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We are a specialty ortho office and have a few questions about the transition of care measure.
Is sending a patient for an MRI, CT...ex. constitute a TOC?
Is sending a patient to the local hospital for one of our physicians to preform surgery a TOC?
Is sending a patient to have an injection without continuing treatment to another physician a TOC?
What are some other examples that specialty clinics are using for their TOC's?
Thanks for your help 🙂
Posted : July 6, 2015 4:52 am
I am not an authority on this, but this is the way we treat these things in our practice. We do not count MRI's etc as TOC's as we do not consider this a referral. We call those tests and we treat the patient upon return even it if means referring them to another provider for care. If that happens then we call it a TOC. Sending the patient for a surgery that we are going to perform, we do not consider a TOC because we are performing the surgery and then we will follow the patient post operatively as well. I believe the last one, for an injection, might be considered a TOC if you are sending the patient for an injection and associated care even if the patient is coming back to you in follow up. I think yu have to decide if you are transitioning the paitent to another level of care or not. Whatever you decide just maintain good documentaion as to why you detrmined that these were or were not a transition of care for audit purposes. The rule is somewhat vague. We consider ourTOC's to be referring to another specialist for a level of care we can not provide even if that specialist happens to be the hospital where we might send a patient to be evaluated urgently for symptoms that we are not going to evaluate and treat due to our specialty. I hope that helps
Posted : July 6, 2015 8:58 am
We do the same thing with our TOC. We only consider those patients we will not be seeing for the same condition again a TOC, for example we don't have a spine specialist so if it becomes surgical, we do a TOC.
I am doing the entire process for TOC so I can prove my exemption from not doing over 100 a reporting period.
I do believe this is one of the measures in the proposed rule changes.
Posted : July 6, 2015 11:46 am
