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  • 1.  Chronic Care Management

    Posted 10-27-2023 07:56

    Hello - We are initiating the Chronic Care Management program in our organization and are wondering if anyone would be willing to share their guidance for the nursing staff to determine the moderate to high complexity medical decision making for billing Complex CCM?  Thank you in advance. 



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    Emily Newbury
    Gundersen Health System
    LaCrosse, WI
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  • 2.  RE: Chronic Care Management

    Posted 10-28-2023 09:37

    I was hoping that Faith Jones would go over that in her talk last week. I am interested in this also



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    Kathleen Boyle
    Mayo Clinic
    Rochester MN
    (253)370-8918
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  • 3.  RE: Chronic Care Management

    Posted 10-29-2023 12:02
    The LACE+ scoring is what we use in my organization.

    Tammye Ross




  • 4.  RE: Chronic Care Management

    Posted 10-29-2023 15:41
    I helped to implement billing for CCM in my institution.  I am not familiar with a need to determine medical complexity.

    Here is a copy of the CMS requirements - as long as these are met the patient qualifies (assuming they have met the other billing requirements such as consent, qualifying visit, etc.

    Chronic care management services, provided personally by a physician or other qualified health care professional, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline, comprehensive care plan established, implemented, revised or monitored; each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

    I along with two other colleagues recently published an article in Nursing Economics which may be helpful for you - the citation is:
    Witwer, S.G., Mattson, A., & Jessie, A.T. (2023).  Registered nurse billing in primary care.  Nursing Economic$, 41 (4), 200-207.

    Stephanie G Witwer, Ph.D., RN, NEA-BC, FAAN
    Department of Nursing
    Emeritus Staff





  • 5.  RE: Chronic Care Management

    Posted 10-29-2023 10:09

    The provider (physician or other qualified healthcare professional) who is responsible for submitting the claim for CCM is accountable and responsible to determine the complexity of medical decision making (straightforward, low, moderate, high). Please refer to a CPT code book for further information.



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    Kimberly Hodge, Ph.D., APRN, ACNS-BC
    317-625-3312
    kshodge@gmail.com
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  • 6.  RE: Chronic Care Management

    Posted 10-30-2023 07:51

    We cover 300K lives in our ACO with a small team. We have had to move away from the traditional definition of 2 or more chronic conditions as that generated too broad of a pool of patients to impact. We just started using EPIC built risk score for risk of admission or ED visit in the next year as it incorporates conditions as well as other demographics such as utilization patterns and zip codes.



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    Kathryn Webner
    Manager
    Orlando Health
    Winter Park FL
    (704)785-0804
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  • 7.  RE: Chronic Care Management

    Posted 10-30-2023 08:43

    Agree with Kimberly's response. MDM is not a nursing function, but rather for the MD/QPP to determine. The grid provided by the AMA when E/M coding requirements were revised can help understand what goes into that determination. 

    https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf



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    Leslie McDowell ANP-BC DNP RN
    QI Specialist / Curriculum Developer
    Northwest AHEC / Wake Forest University School of Medicine
    Winston Salem NC
    (336)972-7852
    ANP-BC DNP RN
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