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9. The patient comes back to the office for recheck in two weeks for scheduled follow-up of atrial fibrillation and hypertension. The basic metabolic (“chem 7”) labs are normal. The patient has no complaints except some mild lower extremity pre-tibial puffiness at the end of the day. The exam is benign and you feel that both of the conditions are stable and you set the patient up for a 2 month follow-up. The bill for this encounter is (using 2021 guidelines on evaluation and management):
1. To bill a Transitional Care Management visit, which of the following must occur (choose the best answer)?
2. TCM services are appropriate after discharge from all of these scenarios, except:
4. TCM documentation requires:
5. CPT 99496 can be billed between calendar day 1-14.
6. For 2021, Transition Care Management services (99495, 99496) can be billed within the same 30 days as Chronic Care Management (CCM) only if (chose one option)
7. The time to bill the TCM (99495, 99496) code is
8. A patient is admitted with new-onset atrial fibrillation. The patient has hypertension (x 22 years) as the only other medical condition. The hospital course was uncomplicated as the patient was
Cardioverted with IV meds in the ED and placed on appropriate medication and stabilized. After two days, she was discharged home. Your office followed the TCM flow correctly and you are seeing the patient in your office on day 5 after discharge. The discharge summary is in the record and you review and make note of such (meds, Echo, and CXR results). The patient has no complaints. Her BP at home has been normal and in the office today is 123/71 but you note that her ACEI was increased in-house due to some BP lability. You feel that the patient is presently stable and you make no additional medication changes, but recommend a 2 week follow-up to insure stability of this new medical condition and a repeat BMET today to make sure electrolytes and renal numbers are stable in your Medicare patient of 30 years. The appropriate bill for this encounter is (using the 2021 MDM guidelines):
10. A 66 year old Medicare patient is here for follow-up after right total hip arthroplasty. He has been hypertensive for 12 years and is on a statin for mild hyperlipidemia. His BMI is 31. You cleared the patient for surgery 3 weeks ago. He was discharged 5 days ago and is at home with home health for outpatient rehab. The hospital stay was uncomplicated except for some hypotension the afternoon after surgery (corrected by withholding medications, IVF bolus) which led to a 3 day hospital stay. His hemoglobin also was low the day after surgery (Hb 8.8, baseline 13), but no transfusions were given. Oral multivitamins with Fe were prescribed by the orthopedic surgeon. All TCM protocols were followed by your staff and after your office evaluation, you find the BP to be stable with no orthostasis and an in-office Hb to be 10.1. Symptomatically, your patient is fine. The discharge summary was fully reviewed which included the labs, an EKG and CXR result. You bill