Transitional Care Management (TCM)

We have been having issues with Humana paying our claims when we bill out a 99495 or 99496.

For example, a patient is discharged from the hospital on January 1st and came in to see his primary care physician for a face-to-face on January 6, would it would be proper to bill a 99496 with a date of service of January 6, understanding that any additional services that pertain to this TCM could not be billed within the 30 days of discharge.

All other payers are paying, including Medicare, except for Humana. We recently had a conference call with some Humana coders who stated that we are doing it wrong and are confused as to how this should be billed. Their explanation to my example was this: If the patient was seen on January 6 for a face-to-face followup from their discharge on January 1, then we have to bill the 99496 with a date of service of January 30 because this would be the last day of TCM.

Does anyone have any insight to this issue because it seems to me that billing a date of service that is not the date that the patient was seen is wrong. Any help in this issue would be very much appreciated.

Transitional Care Management (TCM)