Coding Guidelines for Principal Care Management – Retinal Physician

Unlike some other “care management” codes that require the physician manage a patient from head to toe, principal care management (PCM) is applicable to a specialty practice such as ophthalmology. This may be a useful addition to your retinal practice.

This article addresses the following questions:

  • What is principal care management?
  • What is “high risk” in this context?
  • What are the required elements of PCM?
  • How is PCM reported on a claim?
  • What is Medicare’s allowable fee for PCM?
  • Can PCM be combined with other services?
  • What documentation is required to support a claim for PCM?

This article was published in Retinal Physician, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Retinal Physician, click on the link below:;a-coding-guidelines-for-principal-car

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