Know When to Use an E/M Code in Place of a CPO Code
Question: We have a patient who is currently eligible for home-based care, and our oncologist is working through the details of the patient’s home care plan. Can this physician’s work be billed using a care plan oversight (CPO) code? Wisconsin Subscriber Answer: No, Medicare does not allow separate billing for the time a provider spends establishing a home health plan via the use of HCPCS codes such as G0181 (Physician or allowed practitioner supervision of a patient receiving Medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans). However, the provider may still be able to report other eligible services that reflect the work performed by using an appropriate evaluation and management (E/M) code, such as 99202-99215 (Office or other outpatient visit for the evaluation and management of a/an new/established patient, which requires a medically appropriate history and/or examination…) Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
