Q: What is Chronic Care Management?
A: Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, lupus, multiple sclerosis and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.
Q: Does doing prior authorizations for medications and tests over the phone or ordering them electronically satisfy the Chronic Care Management (CCM) scope of service?
A: The CCM scope of service includes “medication reconciliation with review of adherence and potential interactions” as well as “oversight of patient self-management of medications.” It is debatable whether time spent on the phone doing prior authorization for medications and tests or time sending in such prior authorization electronically would count for this purpose. At this point, it is probably safer not to count time spent on prior authorizations as CCM time, although CMS has not explicitly addressed the question.
Q: If we don’t do 20 minutes of CCM in a month, but our work over two or three months adds up to 20 minutes, can we bill at that time for a month?
A: No. Code 99490 is for 20 minutes “per calendar month.” You cannot add time up over multiple months to report 99490.
Q: Can the case manager of a Medicare Shared Savings Program accountable care organization (MSSP ACO) who works under the physician’s direction be counted for doing work outside of the office? It appears so as long as we record it.
A: If the MSSP ACO case manager is a clinical staff person and the work that he or she does otherwise meets Medicare’s “incident to” rules relative to the physician who will be reporting 99490 (understanding that, for CCM, CMS allows “incident to” services to be provided under general, rather than direct, supervision), then his or her time may be counted toward the 20 minutes necessary to report code 99490, where appropriate.
Dashboard gives detailed actionable insights for better care coordination with patients. Each data is visually represented and the user can gather detailed information by clicking the desired data. The dashboard also displays the follow-up reminders that can be set up by the user against each patient.
The solution puts patients in the center of care delivery through secure telemedicine capabilities and automates recording of CCM logs enabling providers to direct more of their time and effort on patients.
Create condition specific and comprehensive care plan for each patient for better care coordination. Simplify and streamline workflow to guide tele-nurses in creating care plan. Update notes against each item of the care plan to help tele-nurses to accurately monitor the progress of patients.
Automate CCM documentation process with our web-based Chronic Care Solution. Integrate with your softphone to accurately record the time spent and conversation of each call for CMS auditing. Ease your transition by importing service information to your billing system and opt to generate a detailed report on patient interactions including care plan.
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