CPT and HCPCS Coding Changes for 2001 Affect Billing
Published on Fri Dec 01, 2000
The American Medical Association made its annual announcement about additions, deletions and modifications last month in Chicago.
Coders reviewing the new manuals will see that the majority of changes for next year affect other specialties like surgery, radiology and pathology, says Daniel S. Fick, MD, associate professor, residency director and medical director for the department of family medicine at the University of Iowa College of Medicine in Iowa City, Iowa. But there are some changes that will apply to family physicians.
Care Plan Oversight Changes
Noteworthy among changes to evaluation and management (E/M) service coding are the revisions made to care plan oversight services (99374-99380), and the addition of codes to describe certification and recertification for Medicare-covered home health services. Revisions to care plan oversight services were made to reflect more clearly the range of settings in which the services may be provided, according to Susan Callaway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C. The new wording specifically notes care provided by a home health agency in the home, domiciliary or equivalent environment like an Alzheimers facility.
In addition, CPT has added language that includes the involvement by other caregivers like nonphysician professionals, she says.
However, the Health Care Financing Agency (HCFA) disagrees with the new descriptors and has implemented new HCPCS codes that describe care plan oversight for Medicare beneficiaries. HCFA preferred to stick with the existing definitions and so added two G codes that will be used for services covered by Medicare, Callaway explains.
These new HCPCS codes are G0181 (physician supervision under care of home health agency [patient not present] requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication [including telephone calls] with other health care professionals involved in patients care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes) and G0182 (... 30 minutes or more), which carry the same definitions as the 2000 version of 99375 and 99378.
HCFA also added two more G codes to describe services provided by family physicians as they certify and recertify patients eligible to receive Medicare-covered home health services:
G0180 physician services for initial certification of Medicare-covered home health services, billable once for a patients home health certification period.
G0179 physician services for recertification of Medicare-covered home health services, billable once for a patients home health certification period.
The first code will be assigned when a patient has not received these service for at least 60 days, Callaway explains, while the second code applies in situations where the patient has received home health [...]
