Neurosurgery Coding Alert

If you're looking for "just the facts," here's a quick list of "Do's and Don'ts" to make your reporting of care plan oversight (CPO) easier.

Do
  make sure the patient is receiving complex care requiring ongoing physician involvement.
  be certain that the patient is receiving covered (home health agency, hospice or nursing facility) services during the CPO period.
  provide and document at least 30 minutes of CPO for every calendar month during which you claim CPO payment.
  make sure that the physician who bills for the CPO services is the same physician who furnished them.
  document in the patient record which services the physician furnished, as well as the date and length of time of the services.
  choose the correct CPO codes for your payer (99374-99380 for private insurers and G0179-G0182 for Medicare, depending on patient location/status) Don't
bill CPO for routine postoperative care the physician provides during a global surgical period.
  bill for Medicare-covered hospice services if the physician is a medical director or employee of the hospice.
  bill for Medicare-covered hospice services if the physician has a significant financial or contractual interest in the home health service.
  bill for services provided "incident-to" a physician's service.
  count travel time, phone calls to the patient's family, informal consults and conversations with other healthcare professionals, or hospital discharge services (99217 or 99238-99239) as a part of CPO.