CCP CCM Billing & CMS Guidelines 4

Question 1

CMS requires that the CCM care plan be stored in a certified EHR. Which meaningful-use certified EHR standard must the system meet?

Accepted Answer

ONC Health IT Certification Program (2015 Edition or later)

Answer

CMS specifies that CCM must be documented in an ONC-certified EHR meeting at least the 2015 Edition standard.

Question 2

Which of the following is a required element of the CCM care plan?

Accepted Answer

List of all treating providers and their roles

Answer

CMS requires the care plan to include a comprehensive list of all health care providers involved in the patient's care and their roles.

Question 3

Add-on code 99439 can be billed for each additional increment of non-complex CCM time beyond the first 20 minutes. What is the duration of each additional increment?

Accepted Answer

20 minutes

Answer

CPT 99439 is billed for each additional 20 minutes of clinical staff CCM time beyond the initial 20 minutes covered by 99490.

Question 4

A rural health clinic (RHC) wants to bill CCM. Under CMS rules, RHCs may bill CCM using which code?

Accepted Answer

G0511, a bundled HCPCS code for general care management

Answer

RHCs and FQHCs bill CCM using HCPCS code G0511, which is a bundled rate separate from the physician fee schedule CPT codes.

Question 5

When must the initiating visit for CCM occur relative to the first month of CCM billing?

Accepted Answer

It must occur before CCM services begin if there is no pre-existing relationship

Answer

If no pre-existing relationship exists, an initiating visit (AWV, IPPE, or comprehensive E&M) is required before CCM services begin.

(CCP) Chronic Care Professional Certification Practice Test

(CCP) Chronic Care Professional Certification Practice Test

CCP CCM Billing & CMS Guidelines 4