Wiki Code g0180

[christymat24]

Please help. My office does alot of patient care through nurse phones calls from the nursing facilities our patient are in. The physician at times has to review the information and sometimes make changes to medications.

What does the last sentence of (per certification period) mean for this HCCPS code.

I feel this is the code that I could bill for these services provided by our office for Medicare.

G0180 - Physician 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 affrim the initial implementations of the plan of care that meets patient's needs, per certifcation period

Thank you in advance with help with this matter

 

[msrd_081002]

RE: Certification period

From the Medicare Claims Processing Manual
B. Physician Certification and Recertification of Home Health Plans of Care

Effective January 1, 2001, two new HCPCS codes for the certification (HCPCS code G0180) and recertification (HCPCS code G0179) and development of plans of care for Medicare-covered home health services were created. These two new HCPCS codes are available only to physicians who are permitted to certify that home health services are required by a patient in accordance with to §1814(a)(2)(C) and §1835(a)(2)(A) of the Act.

The home health agency certification code (HCPCS code G0180) can be billed only when the patient has not received Medicare-covered home health services for at least 60 days. . The home health agency recertification code (HCPCS code G0179) is used after a patient received services for at least 60 days (or one certification period) when the physician signs the certification after the initial certification period. HCPCS code G0179 will be reported only once every 60 days, except in the rare situation when the patient starts a new episode before 60 days elapses and requires a new plan of care to start a new episode.


Thanks

 

[msbuchanan]

Revenue Code for G0180

Help, I am an FQHC, what revenue code do you use for G0179 and G0180. Medicare is denying my claims. Thank you!

 

[aorgill]

Can G0180 have a DOS for after the patient passed away? The physician reviewed this the day after the patient passed and Medicare denied.

 

[lgardner]

Can G0180 have a DOS for after the patient passed away? The physician reviewed this the day after the patient passed and Medicare denied.

no.
the provider must have signed the certification on a date BEFORE the patient passed away.
if the provider signed on or after the date of death, it is not billable.