Neurosurgery Coding Alert

You should choose your care plan oversight (CPO) codes according to the payer you are dealing with. Private insurers generally accept CPT codes 99374-99380, depending on the site of care (home health agency, hospice or nursing facility), while Medicare payers accept only HCPCS codes G0179-G0182 (also according to the patient's location).

Although the two code series describe similar services, Medicare requires that the physician spend a minimum of 30 minutes per calendar month to report CPO services, while CPT allows billing for services of 15-29 minutes (for example, 99374) or for 30 minutes or more per calendar month (99375).

99374 - Physician supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (e.g., Alzheimer's facility) ... within a calendar month; 15-29 minutes
99375 - ... 30 minutes or more
99377 - Physician supervision of hospice patient ...; 15-29 minutes
99378 - ... 30 minutes or more
99379 - Physician supervision of a nursing facility patient ...; 15-29 minutes
99380 - ... 30 minutes or more
G0179 - Physician re-certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per re-certification period
G0180 - Physician certification ...
G0181 - Physician supervision of a patient receiving Medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care ..., 30 minutes or more
G0182 - Physician supervision of a patient under a Medicare-approved hospice ... Other activities that you may count toward CPO but that are not specifically mentioned in the above descriptors include time devoted to medical decision-making, coordination of services to be performed by the physician (if the coordination of activities requires physician skill), and documenting the services provided (such as describing services in the patient's chart, decision-making performed, and documenting time).