Pulmonology Coding Alert

Question: When the pulmonologist performs monthly care plan oversight (CPO) for a Medicare patient, does it matter if he meets the patient face-to-face? Also, what activities count toward CPO service time?

Answer: CPO does not constitute a face-to-face service. Your pulmonologist does not need to report a visit at the same time he submits a claim for CPO service codes G0181 (Physician supervision of a patient receiving Medicare-covered services provided by a participating home health agency ...) or G0182 (Physician supervision of a patient under a Medicare-approved hospice ...).

However: The pulmonologist must observe some strict rules in order to report these codes. Medicare payers count only certain activities toward the 30-minute minimum for G0181 and G0182 sessions. Here's a list of tasks that count toward CPO time (from CMS IOM 100 -- 4 Chapter 12: Care Plan Oversight Services):

-- Answers to You Be the Coder and Reader Questions answered/reviewed by Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta; and Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.