tammygiessregen
Contributor
Can a MD bill for the completion of hospice paperwork? If so what is the appropriate code for it?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Can a physician bill for the completion of hospice paperwork
- Thread starter tammygiessregen
- Start date
Care Plan Oversight
There are Care Plan Oversight codes you may bill for this. It is for all the time spent in a particular calendar month.
99377 Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes
99378 30 minutes or more
For Medicare patients, use
G0182 Physician supervision of a patient under a Medicare-approved hospice (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 the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
The physician must document somewhere how much time spent, when and doing what. From my recall, it does not need to be very detailed but could be something like:
02/20/19 16 minutes reviewing disease progression, labwork, radiology and completing hospice initial intake forms
02/22/19 8 minutes reviewed new labwork and adjusted losartan from 80mg to 40mg
02/27/19 9 minutes discussed patient's pain with hospice physician (Dr. Jones). Adjusting Percocet to every 3 hours as needed.
If billing G0182 to Medicare, you should review your MACs requirements.
CPO: Hospice
Submit HCPCS code G0182 for CPO services provided to patients that have elected hospice benefits under Medicare and who are in a Medicare-approved hospice.
Claim submission:
•The patient does not have to be present in order for CPO services to be provided and claims submitted to Medicare.
•The HHA or Hospice Provider Number is required on claims for CPO (HCPCS codes G0181 and G0182). ◦Electronic claims: submit the HHA's or hospice's NPI, as appropriate, in loop 2300, ref segment, with qualifier 1J.
◦Paper claims: submit the HHA's or hospice's NPI, as appropriate, in Item 23.
•Dates of service:
◦For HCPCS codes G0181 and G0182, submit the first and last date during which documented care planning services were actually provided during the calendar month.
Do not submit the first and last calendar date of the month unless services were provided on those dates
Submit the claim after the end of the month in which the service is performed
Report care planning only once per calendar month
Report only one month of services per line item
◦For HCPCS codes G0179 and G0180, submit the date physician signed the certification or re-certification.
•Place of service: submit the place of service code that corresponds to where the CPO services were provided.
•Submit CPT codes 99201-99263 and 99281-99357 only when there has been a face-to-face meeting/encounter.
Documentation:
•Claims for care plan oversight services will be denied when review of the beneficiary's claims history shows that there was no covered physician service requiring a face-to-face encounter by the same physician during the six months preceding the provision of the first care plan oversight service.
•Medical records for these service must indicate: ◦For HCPCS codes G0181 and G0182, the physician spent 30 minutes or more for countable care planning activities
◦The specific service furnished, including the date and length of time
Honestly, in our practice, we decided the amount of additional time & effort was not worth it and do not bill these codes.
Hope this helps!
There are Care Plan Oversight codes you may bill for this. It is for all the time spent in a particular calendar month.
99377 Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes
99378 30 minutes or more
For Medicare patients, use
G0182 Physician supervision of a patient under a Medicare-approved hospice (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 the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
The physician must document somewhere how much time spent, when and doing what. From my recall, it does not need to be very detailed but could be something like:
02/20/19 16 minutes reviewing disease progression, labwork, radiology and completing hospice initial intake forms
02/22/19 8 minutes reviewed new labwork and adjusted losartan from 80mg to 40mg
02/27/19 9 minutes discussed patient's pain with hospice physician (Dr. Jones). Adjusting Percocet to every 3 hours as needed.
If billing G0182 to Medicare, you should review your MACs requirements.
CPO: Hospice
Submit HCPCS code G0182 for CPO services provided to patients that have elected hospice benefits under Medicare and who are in a Medicare-approved hospice.
Claim submission:
•The patient does not have to be present in order for CPO services to be provided and claims submitted to Medicare.
•The HHA or Hospice Provider Number is required on claims for CPO (HCPCS codes G0181 and G0182). ◦Electronic claims: submit the HHA's or hospice's NPI, as appropriate, in loop 2300, ref segment, with qualifier 1J.
◦Paper claims: submit the HHA's or hospice's NPI, as appropriate, in Item 23.
•Dates of service:
◦For HCPCS codes G0181 and G0182, submit the first and last date during which documented care planning services were actually provided during the calendar month.
Do not submit the first and last calendar date of the month unless services were provided on those datesSubmit the claim after the end of the month in which the service is performedReport care planning only once per calendar monthReport only one month of services per line item◦For HCPCS codes G0179 and G0180, submit the date physician signed the certification or re-certification.
•Place of service: submit the place of service code that corresponds to where the CPO services were provided.
•Submit CPT codes 99201-99263 and 99281-99357 only when there has been a face-to-face meeting/encounter.
Documentation:
•Claims for care plan oversight services will be denied when review of the beneficiary's claims history shows that there was no covered physician service requiring a face-to-face encounter by the same physician during the six months preceding the provision of the first care plan oversight service.
•Medical records for these service must indicate: ◦For HCPCS codes G0181 and G0182, the physician spent 30 minutes or more for countable care planning activities
◦The specific service furnished, including the date and length of time
Honestly, in our practice, we decided the amount of additional time & effort was not worth it and do not bill these codes.
Hope this helps!
tammygiessregen
Contributor
Thanks so much Christine! I appreciate your help!