99490 Chronic Care Management

99490 Chronic Care Management: A Deep Dive into its Evolution and Current Significance

Author: Dr. Eleanor Vance, MD, FACP, CCM

Dr. Eleanor Vance is a board-certified internist with over 20 years of experience in primary care, specializing in chronic disease management. She is a Certified Chronic Care Manager (CCM) and a Fellow of the American College of Physicians. Her extensive experience in implementing and optimizing 99490 chronic care management services, coupled with her academic background in healthcare policy, makes her uniquely qualified to analyze this complex billing code and its impact on patient care.

Publisher: The American Medical Association (AMA) Journal of Coding and Compliance

The American Medical Association (AMA) is a leading authority on medical coding, billing, and compliance. Their journal provides in-depth analysis and guidance on medical billing procedures, making them a highly credible source for information related to 99490 chronic care management.

Editor: Mr. David Miller, CPC, CPMA, CHC

Mr. David Miller is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), and Certified Healthcare Compliance professional (CHC). His extensive experience in medical billing and compliance ensures the accuracy and clarity of the information presented in this article.

Keywords: 99490 chronic care management, chronic care management billing, Medicare chronic care management, telehealth chronic care management, CCM, CPT code 99490, remote patient monitoring, chronic disease management, value-based care.

1. The Genesis of 99490 Chronic Care Management: A Historical Context

The development of CPT code 99490, chronic care management, reflects a significant shift in healthcare's approach to chronic conditions. Prior to its implementation, the fee-for-service model often left patients with multiple chronic conditions struggling to navigate fragmented care. This led to poor outcomes, increased hospitalizations, and escalating healthcare costs. Recognizing this limitation, Medicare introduced the 99490 chronic care management code in 2015 as part of a broader effort to transition towards value-based care. This code incentivized providers to deliver comprehensive, coordinated care for patients with multiple chronic conditions, emphasizing preventative measures and proactive management rather than solely reactive treatment. The initial implementation faced challenges, including provider education and technology adoption, but it laid the foundation for a more holistic approach to chronic disease management.

2. Understanding the Requirements of 99490 Chronic Care Management

The 99490 chronic care management code encompasses a wide range of services. To qualify for billing, a patient must meet specific criteria: they must have two or more chronic conditions expected to last at least 12 months or until the death of the patient, and these conditions must place the individual at significant risk of death, acute exacerbation/decompensation, or functional decline. The services provided under 99490 include comprehensive care planning, patient education and self-management support, care coordination, communication with other healthcare providers, and follow-up services. The minimum time commitment for these services is at least 30 minutes per calendar month, which is non-face-to-face. These requirements are crucial for accurate billing and compliance with Medicare guidelines. Failure to meet these criteria can result in denied claims and potential financial penalties. The implementation of 99490 has encouraged providers to adopt various technological solutions to enhance communication and patient engagement; this includes the integration of remote patient monitoring (RPM) and telehealth platforms.

3. The Role of Technology in 99490 Chronic Care Management

Technology has played a vital role in making 99490 chronic care management more efficient and accessible. Remote patient monitoring (RPM) allows for the continuous collection of physiological data, such as blood pressure, weight, and blood glucose levels, directly from the patient's home. This data enables proactive interventions, preventing potential crises and optimizing treatment plans. Telehealth platforms facilitate virtual communication between patients and providers, improving access to care, especially for individuals in rural or underserved areas. Integrating these technologies into 99490 chronic care management workflows is crucial for maximizing the value and impact of these services. The efficient use of technology not only improves patient outcomes but also enhances the cost-effectiveness of the program.

4. 99490 Chronic Care Management and Value-Based Care

The introduction of 99490 chronic care management is a cornerstone of the shift towards value-based care. By reimbursing providers for proactive, coordinated care, Medicare aims to improve patient outcomes and reduce overall healthcare costs. The code encourages a paradigm shift away from a fee-for-service model, where providers are compensated for individual services, towards a system that rewards the effective management of chronic conditions, preventing costly hospitalizations and complications. The success of 99490 chronic care management in achieving these goals is continually evaluated and refined through ongoing research and data analysis.

5. Challenges and Opportunities in 99490 Chronic Care Management

Despite its significant potential, implementing 99490 chronic care management presents several challenges. These include adequate staffing and training to manage the increased workload, the need for effective communication and coordination among healthcare providers, and the integration of technology into existing workflows. Furthermore, ensuring accurate documentation to support billing is crucial, requiring robust electronic health record (EHR) systems and well-defined clinical pathways. Addressing these challenges is critical to maximizing the effectiveness of 99490 and realizing the full potential of value-based care. Opportunities lie in further innovation in remote patient monitoring technologies, improved data analytics to identify at-risk patients, and the development of more sophisticated care coordination models.

Conclusion

CPT code 99490 chronic care management represents a significant advancement in healthcare, moving towards a more proactive and holistic approach to managing chronic conditions. While challenges remain in its implementation, its impact on improving patient outcomes and reducing healthcare costs is undeniable. The continued evolution of technology and the ongoing refinement of care coordination models promise to further enhance the effectiveness and reach of 99490 chronic care management, solidifying its role in the future of value-based healthcare.

FAQs

1. What are the specific chronic conditions that qualify for 99490 chronic care management? The specific conditions aren't listed, but rather the criteria of having at least two chronic conditions expected to last at least a year, causing significant risk of death, acute exacerbation, or functional decline. Examples include diabetes, heart failure, COPD, etc.

2. How is 99490 chronic care management different from other types of Medicare services? 99490 focuses on proactive, coordinated care for multiple chronic conditions, aiming to prevent complications, unlike fee-for-service models focused on individual visits.

3. What technology is commonly used in 99490 chronic care management? Remote patient monitoring (RPM) devices (blood pressure cuffs, weight scales, etc.) and telehealth platforms for virtual communication are commonly used.

4. Who is responsible for billing for 99490 chronic care management? The physician or other qualified healthcare professional providing the services is responsible for billing.

5. What are the potential penalties for incorrectly billing 99490 chronic care management? Incorrect billing can lead to claim denials, audits, and potential financial penalties from Medicare.

6. Can 99490 chronic care management be provided via telehealth? Yes, a significant portion of the services can be delivered through telehealth platforms.

7. How does 99490 chronic care management contribute to value-based care? It shifts focus from volume to value, rewarding providers for improved patient outcomes and reduced healthcare utilization.

8. What is the role of the care coordinator in 99490 chronic care management? The care coordinator plays a vital role in coordinating care, communicating with providers, and ensuring the patient receives comprehensive care.

9. What are the key performance indicators (KPIs) used to measure the success of 99490 chronic care management? KPIs might include reduced hospital readmissions, improved patient reported outcomes, and increased patient satisfaction.

1. "Optimizing 99490 Chronic Care Management Through Remote Patient Monitoring": This article explores the effective integration of RPM devices and strategies to enhance the efficiency and outcomes of 99490 services.

2. "Telehealth and 99490 Chronic Care Management: Expanding Access to Care": This article examines the role of telehealth in expanding access to chronic care management services, particularly for patients in rural or underserved areas.

3. "Documentation Best Practices for 99490 Chronic Care Management Billing": This article provides detailed guidance on proper documentation to ensure successful billing and compliance with Medicare guidelines.

4. "The Impact of 99490 Chronic Care Management on Healthcare Costs and Patient Outcomes": This article presents a comprehensive analysis of the program's effect on reducing hospitalizations and improving quality of life.

5. "Staffing and Training Strategies for Successful 99490 Chronic Care Management Implementation": Focuses on the necessary training and support needed for medical staff to effectively manage 99490 services.

6. "Integrating 99490 Chronic Care Management with Other Value-Based Care Models": Explores the synergy between 99490 and other value-based care initiatives.

7. "Addressing Challenges in 99490 Chronic Care Management: Case Studies and Solutions": Presents real-world scenarios and effective solutions to common challenges encountered during implementation.

8. "The Future of 99490 Chronic Care Management: Emerging Technologies and Trends": Discusses future directions in technology and care models that may impact 99490.

9. "Legal and Compliance Considerations for 99490 Chronic Care Management": This article focuses on the legal aspects and regulatory compliance needed for proper billing and risk mitigation.

99490 chronic care management: The Physician Billing Process Deborah L. Walker, Sara M. Larch, Elizabeth W. Woodcock, 2004 Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.
99490 chronic care management: Individualized Care Riitta Suhonen, Minna Stolt, Evridiki Papastavrou, 2018-08-22 This contributed book is based on more than 20 years of researches on patient individuality, care and services of the continuously changing healthcare system. It describes how research results can be used to respond to challenges on individuality in healthcare systems. Service users’, patients’ or clients’ point of views on care and health services are urgently needed. This book describes the conceptualisation of the individualized nursing care phenomenon and the process development of the measuring instruments of that phenomenon in different contexts. It describes results from a variety of clinical contexts about individualized nursing care and explains factors associated with the perceptions and delivery of individualized nursing care from different point of views. This book may appeal to clinicians, nurses practitioners and researchers from many fields.
99490 chronic care management: Families Caring for an Aging America National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Committee on Family Caregiving for Older Adults, 2016-12-08 Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
99490 chronic care management: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
99490 chronic care management: CPT Changes 2022: An Insider's View American Medical Association, 2021-11 For a better understanding of the latest revisions to the CPT(R) code set, rely on the CPT(R) Changes 2022: An Insider's View. Get the insider's perspective into the annual changes in the CPT code set directly from the American Medical Association.
99490 chronic care management: Conquer Medical Coding 2018 Jean Juek, Stacey Mosay, DaphneNeris, 2017-12-25 Take a real-world approach to coding that prepares you for the AAPC or AHIMA certification exams and for professional practice in any health care setting. The book is also a handy resource you can turn to throughout your career. Unique decision trees show you how to logically assign a code. It's the only text that breaks down the decision-making process into a visual and repeatable process! You’ll learn exactly how to select the correct ICD-10, CPT, and HCPCS codes. Each section parallels the Official Coding Guidelines, with a special emphasis on commonly used codes. A wealth of learning tools and tips, along with critical-thinking exercises and real-life case studies, provide the practice you need to master coding. Brief reviews of A&P and pathophysiology put the codes into perfect context.
99490 chronic care management: Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts Loureen Downes, Lilly Tryon, 2023-10-05 Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts is a unique new resource that is not afraid to address lifestyle concepts that can change the trajectory of healthcare in the United States and globally. It provides practical, evidence-based approaches to reduce the pandemic of preventable lifestyle-related chronic diseases such as heart disease, hypertension, some strokes, type 2 diabetes, obesity, and multiple types of cancer. It provides nurse practitioners and physician assistants with the lifestyle management tools needed to contribute to a higher level of care to promote health and prevent disease. The authors take a deep dive into the literature regarding lifestyle concepts and practical management of lifestyle-related chronic diseases. They discuss the root causes of diseases and approaches for patient-centered care, strategies for health promotion reimbursement, and trending telehealth delivery of health care.
99490 chronic care management: CMSA Core Curriculum for Case Management Hussein M. Tahan, Teresa M. Treiger, 2016-07-05 The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation
99490 chronic care management: Step-By-Step Medical Coding, 2016 Edition Carol J. Buck, Jackie L. Grass, 2015-12-02 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From bestselling author Carol J. Buck, Step-by-Step Medical Coding, 2016 Edition is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Practice exercises follow each 'step' of information to reinforce your understanding of important concepts. In-depth coverage includes reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, with an Evolve website that includes 30-day access to TruCode? Encoder Essentials. No other text so thoroughly covers all coding sets in one source! 30-day access to TruCode? Encoder Essentials and practice exercises on the Evolve companion website provide additional practice and help you understand how to utilize an encoder product. A step-by-step approach makes it easier to build skills and remember the material. Over 475 illustrations include medical procedures and conditions to help you understand the services being coded. Real-world coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. Dual coding includes answers for both ICD-10 and ICD-9 for every exercise, chapter review, and workbook question to help you ease into the full use of ICD-10. Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. From the Trenches, Coding Shots, Stop!, Caution!, Check This Out!, and CMS Rules boxes offer valuable tips and helpful advice for working in today's medical coding field. Four coding-question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answers. Official Guidelines for Coding and Reporting boxes allow you to read the official wording for inpatient and outpatient coding alongside in-text explanations. Coders' Index makes it easy to quickly locate specific codes. Appendix with sample Electronic Health Record screenshots provides examples similar to the EHRs you will encounter in the workplace. Online practice activities on Evolve include questions such as multiple choice, matching, fill-in-the-blank, and coding reports. A workbook corresponds to the textbook and offers review and practice with more than 1,200 theory, practical, and report exercises (odd-numbered answers provided in appendix) to reinforce your understanding of medical coding. Available separately. NEW! Separate HCPCS chapter expands coverage of the HCPCS code set. UPDATED content includes the latest coding information available, promoting accurate coding and success on the job.
99490 chronic care management: CPT Changes 2021: An Insider's View American Medical Association, 2020-11-02 For a better understanding of the latest revisions to the CPT® code set, rely on the best-selling CPT® Changes 2021: An Insider's View. Find the meaning behind all the changes included in the AMA's CPT® 2021 Professional Edition codebook. Invest in this annual publication and get the insider's perspective into the CPT code set directly from the source--the American Medical Association. AMA is the authority to turn to when seeking an official interpretation and explanation for a CPT code or guideline change. Know the changes inside and out. Avoid and reduce claim denials. FEATURES AND BENEFITS Organizational structure like the CPT codebook -- allows coders to easily conduct a side-by-side read of CPT® Changes with the CPT® Professional Official AMA rationales -- provide a detailed explanation for the code or guideline change Clinical examples, procedural descriptions and illustrations -- help explain the practical application for each change At-a-glance summary table of the 2021 changes in each section -- shows the extent to which that changes affect a specialty
99490 chronic care management: Health Care Transition Albert C. Hergenroeder, Constance M. Wiemann, 2018-05-03 This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.
99490 chronic care management: Step-by-Step Medical Coding, 2017 Edition - E-Book Carol J. Buck, 2016-11-08 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From Carol J. Buck, the bestselling Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Practice exercises follow each 'step' of information to reinforce your understanding of important concepts. In-depth coverage includes reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, with an Evolve website that includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - 30-day access to TruCode® Encoder Essentials (in addition to separate encoder practice exercises on the Evolve companion website) help you understand how to utilize an encoder. - A step-by-step approach makes it easier to build skills and remember the material. - UNIQUE! Real-world coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Over 500 illustrations include medical conditions and procedures to help you understand the services being coded. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - UNIQUE! Four coding-question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answers. - Official Guidelines for Coding and Reporting boxes allow you to read the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - UNIQUE! Coders' Index makes it easy to quickly locate specific codes. - Sample Electronic Health Record screenshots in the appendix provide examples similar to the EHRs you will encounter in the workplace. - Online practice activities on Evolve include questions such as multiple choice, matching, fill-in-the-blank, and coding reports. - A workbook corresponds to the textbook and offers review and practice with more than 1,200 theory, practical, and report exercises (odd-numbered answers provided in appendix) to reinforce understanding of medical coding. Available separately. - Medical Coding Online uses animations, photographs, drawings, narrated slide shows, case-based exercises, pop-up definitions, and professional insights to reinforce coding concepts from the Step-by-Step text. Available separately.
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99490 chronic care management: Understanding Health Information Systems for the Health Professions Jean A Balgrosky, 2019-03-19 Covering the principles of HIS planning, cost effectiveness, waste reduction, efficiency,population health management, patient engagement, and prevention, this text is designed for those who will be responsible for managing systems and information in health systems and provider organizations.
99490 chronic care management: Step-by-Step Medical Coding, 2018 Edition - E-Book Carol J. Buck, 2017-11-07 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From Carol J. Buck, the bestselling Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Explanations of coding concepts are followed by practice exercises to reinforce understanding of the material. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build your skills and remember the material. - 30-day trial access to TruCode® Encoder Essentials gives you experience with using an encoder (in addition to separate encoder practice exercises on the Evolve website). - Learning Objective Review questions are included at the end of each chapter. - UNIQUE! Concrete real-life coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Instructor-led assessments on the companion Evolve website provide additional assessment options in classroom settings (answers and rationales provided at the discretion of your instructor). - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - Over 450 total illustrations help you understand the types of medical conditions and procedures being coded, along with examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample electronic health record screenshots (located in Appendix D) show examples similar to the EHRs you will encounter in the workplace. - NEW! Updated content includes the latest coding information available, promoting accurate coding and success on the job. - NEW! Glossary review questions are included at the end of each chapter.
99490 chronic care management: Medical Fee Schedule , 1995
99490 chronic care management: Step-by-Step Medical Coding, 2015 Edition - E-Book Carol J. Buck, 2014-11-18 Take your first step toward a successful career in medical coding with in-depth coverage from the most trusted name in coding education! From Carol J. Buck, Step-by-Step Medical Coding, 2015 Edition is a practical, easy-to-use resource that shows you exactly how to code using all current coding systems. Explanations of coding concepts are followed by practice exercises to reinforce your understanding. In addition to coverage of reimbursement, ICD-9-CM, CPT, HCPCS, and inpatient coding, this edition fully covers ICD-10-CM in preparation for the transition to ICD-10. No other text on the market so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build skills and remember the material. - Dual coding addresses the transition to ICD-10 by providing coding answers for both ICD-10 and ICD-9. - Over 500 illustrations include medical procedures and conditions that help you understand the services being coded, and images from Carol J. Buck's professional ICD and HCPCS manuals that familiarize you with the format of professional coding manuals. - Real-life coding reports simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Complete coverage of ICD-10-CM prepares you for the transition to ICD-10. - A workbook corresponds to the textbook and offers review and practice with more than 1,500 questions, activities, and terminology exercises to reinforce your understanding of medical coding. Available separately. - Official Guidelines for Coding and Reporting boxes allow you to read the official wording for inpatient and outpatient coding alongside in-text explanations. - Four coding question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answer blanks. - From the Trenches, Coding Shots, Stop!, Caution!, Check This Out!, and CMS Rules boxes offer valuable tips and helpful advice for working in today's medical coding field. - Coder's Index makes it easy to quickly locate specific codes. - Appendix with sample EHR (Electronic Health Record) screenshots provides examples similar to the EHRs you will encounter in the workplace. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - NEW! Encoder practice exercises on the companion Evolve website provide added practice and help you understand how to utilize an encoder product. - UPDATED content includes the latest coding information available, promoting accurate coding and success on the job.
99490 chronic care management: Medical Fees James B. Davis, Practice Management Information Corporation, Context4 Healthcare, Inc, 2013
99490 chronic care management: Buck's Step-by-Step Medical Coding, 2021 Edition Elsevier, 2020-11-08 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! - Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. - A step-by-step approach makes it easier for students to build coding skills and remember the material. - Learning objective and glossary review questions reinforce student understanding of key chapter concepts and terms. - 30-day trial to TruCode® Encoder Essentials gives students experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). - UNIQUE! Real-life coding reports (cleared of any confidential information) simulate the reports students will encounter as coders, and help them apply coding principles to actual cases. - Online activities on Evolve provide extra practice with assignments, including coding reports. - More than 450 illustrations help in understanding the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop students' coding ability and critical thinking skills. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records students will encounter in the workplace. - NEW! Coding updates include the latest information available, promoting accurate coding and success on the job. - NEW! Coverage of CPT E/M Guidelines changes for Office and Other Outpatient codes.
99490 chronic care management: Step-by-Step Medical Coding, 2016 Edition - E-Book Carol J. Buck, 2015-12-01 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From bestselling author Carol J. Buck, Step-by-Step Medical Coding, 2016 Edition is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Practice exercises follow each 'step' of information to reinforce your understanding of important concepts. In-depth coverage includes reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, with an Evolve website that includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - 30-day access to TruCode® Encoder Essentials and practice exercises on the Evolve companion website provide additional practice and help you understand how to utilize an encoder product. - A step-by-step approach makes it easier to build skills and remember the material. - Over 475 illustrations include medical procedures and conditions to help you understand the services being coded. - Real-world coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Dual coding includes answers for both ICD-10 and ICD-9 for every exercise, chapter review, and workbook question to help you ease into the full use of ICD-10. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - From the Trenches, Coding Shots, Stop!, Caution!, Check This Out!, and CMS Rules boxes offer valuable tips and helpful advice for working in today's medical coding field. - Four coding-question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answers. - Official Guidelines for Coding and Reporting boxes allow you to read the official wording for inpatient and outpatient coding alongside in-text explanations. - Coders' Index makes it easy to quickly locate specific codes. - Appendix with sample Electronic Health Record screenshots provides examples similar to the EHRs you will encounter in the workplace. - Online practice activities on Evolve include questions such as multiple choice, matching, fill-in-the-blank, and coding reports. - A workbook corresponds to the textbook and offers review and practice with more than 1,200 theory, practical, and report exercises (odd-numbered answers provided in appendix) to reinforce your understanding of medical coding. Available separately. - NEW! Separate HCPCS chapter expands coverage of the HCPCS code set. - UPDATED content includes the latest coding information available, promoting accurate coding and success on the job.
99490 chronic care management: Buck's Step-by-Step Medical Coding, 2022 Edition - E-Book Elsevier, 2021-11-24 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! - Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. - A step-by-step approach makes it easier to build your coding skills and remember the material. - Learning objective and glossary review questions reinforce your understanding of key chapter concepts and terms - 30-day trial to TruCode® Encoder Essentials gives you experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). - UNIQUE! Real-life coding reports simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Online activities on Evolve provide extra practice with assignments, including coding reports. - More than 450 illustrations help you understand the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records you will encounter in the workplace. - NEW! Coding updates include the latest information available, promoting accurate coding and success on the job. - Coverage reflects the latest CPT E/M guidelines changes for office and other outpatient codes.
99490 chronic care management: New Directions in Geriatric Medicine Lee Ann Lindquist, 2016-04-09 This book is designed to present the clinical geriatric trends within general internal medicine and family practice, which practitioners often encounter in caring for their older adult patients. Chapters focus on increasingly difficult clinical decisions that practitioners have to make in caring for older adults, who often experience medical complications due to memory loss, physical disability, and multiple chronic conditions. Written by experts in geriatric medicine, each of these chapters start with the most up-to-date clinical geriatric research and provide specific examples or case studies on how to use this information to address the clinical needs of older adult patients. In addition, there is a set of concise “take-home points” for each chapter that are easy to commit to memory and implement in clinical care of aging patients. As the only book to focus on current trends in geriatric research and evidence-based eldercare practice, Clinical Trends in Geriatric Medicine is of great value to internists, family practitioners, geriatricians, nurses, and physician assistants who care for older adults.
99490 chronic care management: Mastering Patient Flow Elizabeth W. Woodcock, 2014-08
99490 chronic care management: Step-By-Step Medical Coding, 2017 Edition Carol J. Buck, 2016-12-06 Resource ordered for the Health Information Technology program 105301.
99490 chronic care management: Using Technology to Improve Care of Older Adults Diane Chau, Thomas Osborne, 2017-08-28 State-of-the-art developments in multiple new technologies for older adult care Grounded in a unique team-based geriatrics perspective, this book delivers a broad range of current, evidence-based knowledge about innovative technology that has the potential to advance the care and well being of older adults. It provides key information about the development, selection, and implementation of technology products, and describes research evidence, education-based initiatives, and systems thinking. The book also examines challenges and barriers to implementation, adoption and innovation. From telehealth and assistive technology in the home to simulation and augmented reality in educational settings, the text provides a hands-on, field-tested articulation of how products can aid in the transitional care process, chronic care delivery, and geriatrics/gerontology education. It discusses technology developments in rural areas, home telehealth, wearable technology, personalized medicine, social robots, technology to assist seniors with cognitive impairments, the potential of artificial intelligence to enhance health care of older adults. The text is written to help health care professionals select the appropriate technology for their needs. Key Features: Describes the most current technology resources, evidence, and developments for older adult care Based on a team-centered approach Written by interprofessional health care providers experienced in implementing, developing and adopting technology to assist older adults Includes case studies depicting technology-related successes and failures Addresses the challenges, barriers, and opportunities for transforming aging with technology across transitions of care
99490 chronic care management: Buck's Step-by-Step Medical Coding, 2020 Edition E-Book Elsevier, 2019-11-28 NEW! Coding updates include the latest information available, promoting accurate coding and success on the job.
99490 chronic care management: The Strategic Project Leader Jack Ferraro, 2014-09-26 As executives build and nurture their organization’s strategic agility in today’s turbulent, uncertain business environment, the ability to lead strategic change has become more critical than ever. The Strategic Project Leader: Mastering Service-Based Project Leadership, Second Edition will help project managers lead with confidence in temporary, ambiguous team structures that execute risk-laden work in an increasingly agile project environment. Like the first edition, this edition encourages readers to take ownership of their leadership agenda and become disciplined in the processes of building a framework of leadership skills. Readers are introduced to a new role: the service-based project leader. This role serves the entire project organization by creating a meaningful experience for team members, customers, and critical stakeholders. The book provides practical guidance to help you move from project manager to service-based project leader. Detailing a framework for developing and refining leadership skills, it explains how to build a leadership competency pyramid and then execute a self-directed plan for building leadership competencies. The leadership competency pyramid includes an intuitive model that will be helpful to project managers at any level. The book elaborates on the components of each layer of the pyramid and how each layer relates to the others. A chapter is dedicated to each layer of the pyramid, with supporting evidence for the necessity of each of these layers, as well as practical advice on how to build and practice these component layers.
99490 chronic care management: Buck's Step-by-Step Medical Coding, 2024 Edition - E-Book Elsevier, 2023-11-20 **Selected for Doody's Core Titles® 2024 with Essential Purchase designation in Health Information Management** Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! - Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. - A step-by-step approach makes it easier to build your coding skills and remember the material. - Learning objective and glossary review questions reinforce your understanding of key chapter concepts and terms - Coverage reflects the latest CPT E/M guidelines changes for office and other outpatient codes. - 30-day trial to TruCode® Encoder Essentials gives you experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). - UNIQUE! Real-life coding reports simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Online activities on Evolve provide extra practice with assignments, including coding reports. - More than 450 illustrations help you understand the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records you will encounter in the workplace. - NEW! Coding updates include the latest information available, promoting accurate coding and success on the job.
99490 chronic care management: Leading an Academic Medical Practice Lee B. Lu,
99490 chronic care management: The Social Transformation of American Medicine Paul Starr, 1982 Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. The definitive social history of the medical profession in America....A monumental achievement.—H. Jack Geiger, M.D., New York Times Book Review
99490 chronic care management: Buck's Step-by-Step Medical Coding, 2019 Edition E-Book Elsevier, 2018-11-05 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Explanations of coding concepts are followed by practice exercises to reinforce understanding of the material. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build your skills and remember the material. - 30-day trial access to TruCode® Encoder Essentials gives you experience with using an encoder (in addition to separate encoder practice exercises on the Evolve website). - Learning Objective and glossary review questions are included at the end of each chapter. - UNIQUE! Concrete real-life coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Instructor-led assessments on the companion Evolve website provide additional assessment options in classroom settings (answers and rationales provided at the discretion of your instructor). - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - Over 450 total illustrations help you understand the types of medical conditions and procedures being coded, along with examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample electronic health record screenshots (located in Appendix D) show examples similar to the EHRs you will encounter in the workplace. - NEW! Updated content includes the latest coding information available, promoting accurate coding and success on the job. - NEW! Additional exercise questions covering the Official Guidelines for Coding and Reporting.
99490 chronic care management: Building a Successful Ambulatory Care Practice: Advancing Patient Care Mary Ann Kliethermes, 2019-12-22 Integration of pharmacists into an outpatient setting is ever-changing. Are you prepared to meet the challenge? Building a Successful Ambulatory Care Practice: Advancing Patient Care, 2nd Edition, builds on the material presented in Kliethermes and Brown’s Building an Effective Ambulatory Care Practice by addressing the changes that have occurred in ambulatory care practice in recent years. It forges ahead into material not covered in the previous book, giving pharmacists both the information they need to make effective plans in the contemporary environment and the tools needed to implement them.
99490 chronic care management: Buck's 2023 Step-by-Step Medical Coding - E-Book Elsevier, 2022-11-27 Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! - Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. - A step-by-step approach makes it easier to build your coding skills and remember the material. - Learning objective and glossary review questions reinforce your understanding of key chapter concepts and terms - 30-day trial to TruCode® Encoder Essentials gives you experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). - UNIQUE! Real-life coding reports simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Online activities on Evolve provide extra practice with assignments, including coding reports. - Coverage reflects the latest CPT E/M guidelines changes for office and other outpatient codes. - More than 450 illustrations help you understand the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records you will encounter in the workplace. - NEW! Coding updates include the latest information available, promoting accurate coding and success on the job.
99490 chronic care management: Living Well with Chronic Illness Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Living Well with Chronic Disease: Public Health Action to Reduce Disability and Improve Functioning and Quality of Life, 2011-06-30 In the United States, chronic diseases currently account for 70 percent of all deaths, and close to 48 million Americans report a disability related to a chronic condition. Today, about one in four Americans have multiple diseases and the prevalence and burden of chronic disease in the elderly and racial/ethnic minorities are notably disproportionate. Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare. Living Well with Chronic Disease identifies the population-based public health actions that can help reduce disability and improve functioning and quality of life among individuals who are at risk of developing a chronic disease and those with one or more diseases. The book recommends that all major federally funded programmatic and research initiatives in health include an evaluation on health-related quality of life and functional status. Also, the book recommends increasing support for implementation research on how to disseminate effective longterm lifestyle interventions in community-based settings that improve living well with chronic disease. Living Well with Chronic Disease uses three frameworks and considers diseases such as heart disease and stroke, diabetes, depression, and respiratory problems. The book's recommendations will inform policy makers concerned with health reform in public- and private-sectors and also managers of communitybased and public-health intervention programs, private and public research funders, and patients living with one or more chronic conditions.
99490 chronic care management: Palliative and End-of-Life Care, An Issue of Nursing Clinics of North America James C. Pace, Dorothy Wholihan, 2016-08-10 The Guest Editors have secured top experts in the area of palliative care to write current and clinically relevant articles. Articles in this issue are devoted to: Caring for LGBT Populations; Integrating Palliative Care into Primary Care; Pain Management in the Cognitively Impaired; Pain Management in the Client with Substance Use Disorder; Rituals at End of Life; Death Bed Phenomena; Family Care During End of Life; Palliative Wound Care; Pet-Assisted Therapy in Palliative Care; Palliative Sedation: State of the Science. Readers will come away with the updated information they need to provide state-of-the-art palliative care to their patients.
99490 chronic care management: Medication Therapy Management, Second Edition Karen Lynn Whalen, 2018-04-05 Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. Discover the medication therapy management solution—with this definitive, up-to-date sourcebook The need to improve the use of medications has major implications for the nation’s healthcare system. Burdened by high costs and an ineffective process of providing medication therapy, the current prescription drug environment poses considerable risks to patient safety. Medication therapy management (MTM) is designed to address these deficiencies—and this essential text gives pharmacists all the right MTM tools to identify and eliminate drug-related problems that can cause potentially severe adverse events. Medication Therapy Management delivers the most relevant insights into MTM—a vital service that is gaining momentum due to the rapid growth of patient-centered care, healthcare information technology, new practice models (e.g., Patient Centered Medical Home), and new payment methods. Cohesively organized, this expert-authored guide begins with an introduction to data sets for MTM, covering essential topics such as establishing quality and performance improvement, the payer perspective, conducting the comprehensive medication review, and reimbursement. The second part of Medication Therapy Management reviews MTM data sets for a wide spectrum of disorders, from asthma and atrial fibrillation to HIV and heart disease. Enhanced by the latest perspectives on therapeutics, including completely up-to-date tables throughout, Medication Therapy Management is a practical, skill-building roadmap for optimizing drug therapy and enhancing patient outcomes. Features • Everything you need to provide successful MTM services and empower patients to take an active role in their medication and overall healthcare • Turnkey disease-based data sets help you apply proven MTM principles to common disorders • Helpful appendices cover therapy management characteristics and answers to key questions; the MTM practice model and training survey; and the Medicare Part D MTM program standardized format
99490 chronic care management: Starting and Maintaining a Successful Dermatology Practice, An Issue of Dermatologic Clinics, E-Book Brett Coldiron, 2023-09-22 In this issue of Dermatologic Clinics, guest editor Dr. Brett Coldiron brings his considerable expertise to the topic of Starting and Maintaining a Successful Dermatology Practice. Top experts in the field discuss key topics such as going solo in a small town; basic legal considerations; economics of a dermatology practice; private equity: the good, the bad, and the ugly; retirement planning; and more. - Contains 17 relevant, practice-oriented topics including asset protection; the road from private practice to academics; political activism and the dermatologist; being a successful businesswoman in dermatology; building a successful solo general and cosmetic dermatology practice; group negotiations when entering a group practice; and more. - Provides in-depth clinical reviews on starting and maintaining a successful dermatology practice, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
99490 chronic care management: COLLABORATE(R) for Professional Case Management Teresa Treiger, Ellen Fink-Samnick, 2015-04-15 This book is about the progressive improvement of case management beyond that which it exists to that of a practice specialty focused on professionalism and collegiality across all practice settings. Our desire to produce a framework for such practice began when we connected several years ago. It was a result of a dialogue; the sharing of our stories and experiences. Separately, we were already passionate about and committed to case management excellence. Together, our vision coalesced to form this competency-based framework for advancing case management captured by an acronym which defined the essence of professional practice---COLLABORATE. We spent hours discussing the implications of a perceived epidemic involving less than productive interactions between individuals working under the title of case manager with consumers, providers, and clinical colleagues. These accumulated experiences heightened our commitment to lead much-needed change. Our conversation endured over many months as we realized a shared: Respect for case management’s rich heritage in healthcare, across professional disciplines and practice settings; Concern for those factors which devalue case management’s professional standing; Agreement that while the practice of case management transcends many representative professional disciplines and educational levels, each stakeholder continues to cling to their respective stake in the ground; and Belief of the importance for case management to move from advanced practice to profession once and for all. COLLABORATE was borne from a vision; the mandate to solidify a foundation for case management practice which combines unique action-oriented competencies, transcends professional disciplines, crosses over practice settings, and recognizes educational levels. The ultimate focus is on improving the client’s health care experience through the promotion of effective transdisciplinary collaboration. COLLABORATE recognizes the hierarchy of competencies and practice behaviors defined by the educational levels of all professionals engaged; associate, bachelors, masters and doctoral degrees across practice disciplines. Through this approach, every qualified health and human service professional has a valued place setting at case management’s ever-expanding table. Each of the competencies are presented as mutually exclusive and uniquely defined however, all are complementary and call on the practitioner to conduct work processes in a wholly integrated manner. While appearing in order for the acronym’s sake, they are not necessarily sequential. Ultimately, case management is an iterative process. When united in a comprehensive and strategic effort, the COLLABORATE competencies comprise a purpose-driven, powerful case management paradigm. The agility of this model extends to use of key concepts that include both action-oriented verbs and nouns, which are significant elements in any professional case management endeavor. To date, case management practice models have been driven by care setting and/or business priorities. Unfortunately, this exclusivity has contributed to a lack of practice consistency due to shifting organizational and regulatory priorities. However, this is only one reason for a fragmented case management identity. COLLABORATE recognizes and leverages these important influencers as critical to successful practice and quality client outcomes. Interprofessional education and teamwork are beginning to emerge as the means to facilitate relationship-building in the workplace. Through this approach, health care practitioners absorb the theoretical underpinning of intentionally work together in a mutually respectful manner which acknowledges the value of expertise of each care team stakeholder. This educational approach provides the opportunity to engage in clinical practice that incorporates the professional standards to which we hold ourselves accountable Innovative and emerging care coordination models, defined by evidence-based initiatives, appear across the industry. Each promotes attention to interprofessional practice in order to achieve quality patient-centered care. Herein lies an opportunity to demonstrate the value drawn from diverse expertise of case managers comprising the collective workforce. However a critical prefacing stage of this endeavor involves defining a core practice paradigm highlighting case management as a profession. The diverse and complex nature of population health mandates that case management intervene from an interprofessional and collaborative stance. While inherent value is derived from the variety of disciplines, this advanced model unifies case management’s unique identity. Now is the time to define and adopt a competence-based model for professional case management. COLLABORATE provides this framework. This text is presented in four sections: Section 1: Historical validation of why this practice paradigm is critical for case management to advance to a profession; Section 2: Presentation of the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; Section 3: Practical application of the book’s content for use by the individual case manager and at the organizational level; and The Epilogue: Summarizes the COLLABORATE approach in a forward-looking context. For the reader with limited time, reviewing Section 2 provides the substantive meat associated with each of the competencies. Our ultimate desire is that the COLLABORATE approach provides an impetus for all stakeholders (e.g., practitioners, educational institutions, professional organizations) to take the necessary steps toward unified practice in order to facilitate the transition of case management considered as a task-driven job to its recognition as being a purpose-driven profession. The book provides a historical validation of why this new practice paradigm is critical for case management to advance as a profession; presents the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; and covers the practical application of the book’s content by individual case managers, and at the organizational level.
99490 chronic care management: Physician Coding Exam Review 2016 Carol J. Buck, 2015-12-07 Prepare to succeed on your physician coding exam with Physician Coding Exam Review 2016: The Certification Step! From leading coding author and educator Carol J. Buck, this exam review provides complete coverage of all topics included on the physician coding certification exam - including anatomy, terminology, and pathophysiology for each body system; reimbursement issues; CPT, HCPCS, and ICD-10-CM coding (with ICD-9-CM posted on Evolve companion website); and more. Four full practice exams simulate the testing experience, include answers and rationales, and provide enough practice to reassure even the most insecure exam-taker. It's the only physician coding exam review you need! Comprehensive review content covers everything you need to know to pass the physician coding certification exam. Mobile-optimized quick quizzes provide extra practice and review with 380 additional medical terminology, pathophysiology, CPT, ICD-10-CM, and HCPCS questions. Practice exams on the Evolve website allow you to assess strengths and weaknesses and develop a plan for focused study, including a Pre-Exam to be taken prior to studying, the same exam again as a Post-Exam to be taken after your review, and a Final Exam that simulates the experience of taking the actual physician coding exam. Answers and rationales to the Pre-/Post- and Final Exams are available on Evolve. Netter's Anatomy illustrations help you understand anatomy and how it affects coding. Real-world coding reports (cleared of any patient identifiers) simulate the reports that you will encounter on the job and challenge you to apply key coding principles to actual cases. Success Strategies section in the text guides you step-by-step through the entire exam process. Concise outline format helps you access information quickly and study more efficiently. Colorful design and illustrations make study and review easier and more engaging. NEW! All diagnosis coding content is updated to ICD-10-CM, preparing you with all the ICD-10-CM information you need for success on the certification exam. Updated content includes the latest coding information available, promoting exam success and accurate coding on the job. NEW! ICD-9-CM versions of Units 4-5 and the practice examinations are posted to the Evolve companion website, so that you are prepared no matter which diagnosis code set is being tested on for your specific exam.
99490 chronic care management: Physician Coding Exam Review 2017 - E-Book Carol J. Buck, 2016-11-14 Prepare to succeed on your physician coding certification exam with Physician Coding Exam Review 2017: The Certification Step! From leading coding author and educator Carol J. Buck, this exam review provides complete coverage of all topics included on the physician coding certification exam — including anatomy, terminology, and pathophysiology for each body system; reimbursement issues; CPT, HCPCS, and ICD-10-CM coding; and more. Four full practice exams simulate the testing experience, include answers and rationales, and provide enough practice to reassure even the most insecure exam-taker. It's the only physician coding exam review you need! - Comprehensive review content covers everything you need to know to pass your physician coding certification exam. - UNIQUE! Practice exams on the Evolve website allow you to assess strengths and weaknesses and develop a plan for focused study, including a Pre-Exam to be taken prior to studying, the same exam again as a Post-Exam to be taken after your review, and a Final Exam that simulates the experience of taking the actual physician coding exam. - Concise outline format helps you access information quickly and study more efficiently. - Mobile-optimized quick quizzes offer on-the-go practice and review with 380 additional medical terminology, pathophysiology, CPT, ICD-10-CM, and HCPCS questions. - Success Strategies section in the text guides you step-by-step through the entire exam process. - UNIQUE! Netter's Anatomy illustrations help you understand anatomy and how it affects coding. - Full-color design and illustrations make study and review easier and more engaging. - UNIQUE! Real-world coding reports (cleared of any patient identifiers) simulate the reports that you will encounter on the job and challenge you to apply key coding principles to actual cases. - Answers and rationales to the Pre-, Post- and Final Exams are available on Evolve. - Updated content includes the latest ICD-10, HCPCS, and CPT code updates, promoting accurate coding and success on the job.
MLN909188 – Chronic Care Management Services - Center…
Chronic Care Management Services MLN Booklet Page 3 of 12 MLN909188 May 2024 CMS recognizes chronic care management (CCM) as . a critical primary care service …

Frequently Asked Questions About Billing Medicare for CCM …
This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS) and Hospital Outpatient …

Chronic Care Management (CCM) - AAFP
Chronic care management can help manage your patients’ chronic conditions more effectively, improve communication among other treating clinicians, and provide a way …

CPT ® 99490, Under Chronic Care Management Services - AAPC
The Current Procedural Terminology (CPT ®) code 99490 as maintained by American Medical Association, is a medical procedural code under the range - Chronic Care …

Chronic Care Management Frequently Asked Questions
Aug 16, 2022 · This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS). What …

MLN909188 – Chronic Care Management Services - Centers …
Chronic Care Management Services MLN Booklet Page 3 of 12 MLN909188 May 2024 CMS recognizes chronic care management (CCM) as . a critical primary care service that contributes …

Frequently Asked Questions About Billing Medicare for CCM …
This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS) and Hospital Outpatient Prospective …

Chronic Care Management (CCM) - AAFP
Chronic care management can help manage your patients’ chronic conditions more effectively, improve communication among other treating clinicians, and provide a way to optimize …

CPT ® 99490, Under Chronic Care Management Services - AAPC
The Current Procedural Terminology (CPT ®) code 99490 as maintained by American Medical Association, is a medical procedural code under the range - Chronic Care Management …

Chronic Care Management Frequently Asked Questions
Aug 16, 2022 · This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS). What chronic care …

2025 Chronic Care Management CPT Codes: Updated Rules
Jan 15, 2025 · CPT 99490 . Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar …

CPT 99490: How to Bill for Chronic Care Management
Feb 27, 2018 · Billing for CPT 99490 and related codes requires knowledge of the CMS Chronic Care Management (CCM) program as a whole, as well as an understanding of how the program …

CPT 99490: Add-On Code Description, Rules & Billing Guide
CPT 99490 is the most frequently billed code for Chronic Care Management (CCM) services. On this page, you’ll find billing rules, eligibility requirements, compliance tips, and practical …

Chronic Care Management CPT Codes & Billing Guide 2025
CPT code 99490 is the primary code for billing non-complex Chronic Care Management (CCM) services. It is used to bill CMS for the first 20 minutes of non-face-to-face CCM care provided …

A Modern Guide to Chronic Care Management (CCM): CPT Codes, Care …
Jan 12, 2021 · Managing chronic conditions requires more than occasional visits—it demands consistent, proactive, and coordinated care. Chronic Care Management (CCM) programs, …

Understanding CPT Code 99490 for Chronic Care Management
Nov 28, 2024 · CPT code 99490 refers to non-face-to-face chronic care management services provided to patients with two or more significant chronic conditions. It is part of Medicare’s …

2024 Chronic Care Management CPT Codes: Cheat Sheet
This code is an add-on to code 99490 with similar patient eligibility criteria of two or more chronic conditions, a significant risk of death, acute exacerbation, or functional decline and the …

99490 cpt code description: Chronic Care Billing | Precision Hub
Jun 3, 2025 · What is the 99490 CPT Code? The 99490 CPT code is used for billing non-face-to-face Chronic Care Management services. These services must be: At least 20 minutes of …

Ten Things To Know Before Billing CPT 99490 - ChartSpan
CPT 99490 covers chronic care management services for qualified patients. Understanding CCM 99490 billing requirements can help you ensure your clinic receives reimbursement for your …

Chronic Care Management | CCM Medicare | CPT® 99490
Nov 7, 2024 · Medical offices often question the correct way to code for Chronic care management. This article reviews the criteria for CPT® 99490, 99487 and 99489.

CPT Code 99490 For Billing Chronic Care Management (CCM) …
Jun 7, 2024 · CPT 99490 is a non-complex CCM code that covers at least 20 minutes of non-face-to-face chronic care management services provided by clinical staff. The average …

How to Bill Chronic Care Management 99490 to Medicare
See how to bill for Medicare's Chronic Care Management (CCM) services using CPT Code 99490. This service is for non-face-to-face coordination of care services for Medicare patients with …

How the 99490 CPT Code Enhances CCM Benefits for Patients
Nov 15, 2024 · The 99490 CPT code plays a crucial role in enhancing Chronic Care Management (CCM) by providing a structured framework for care coordination. This improves patient …

Chronic care management: lots of questions and a few answers
Dec 24, 2014 · Q4. When billing 99490, do we use the diagnosis codes for the two chronic care conditions we are using? I would think so but haven't found guidance so far. A4.

Billing Rules for CPT 99490 & Other Chronic Care Management …
Mar 20, 2024 · CPT Code 99490 is used for billing chronic care management. It involves time spent providing comprehensive care coordination, reviewing lab or imaging results, and …

99490 Chronic Care Management