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Coding for G0182

anuja.devasthali

anuja.devasthali

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53
Location
Mumbai, Maharashtra
Hi Friends,

Please help me with this !:confused:

Our PCP provides supervision for a patient enrolled in Medicare approved hospice. We are using CPT G0182 for it . Insurance company has denied the claim stating below mentioned 2 reasons :
1. Patient is enrolled in Hospice
2. Provider is not attending physician

How to code for this case ?
Do we need to add GW modifier or something else.

Anuja.
 
Are any other services on the claim with G0182. If so, try billing it with no other services on the claim and make sure you are billing it after the month in which you said the care plan oversight took place. Also, if the date range is across calendar months that might be causing problems.
 
One more thing...is the physician billing for this service the designated attending physician? When the patient is enrolled into hospice they have give the name of their attending physician. You can contact the hospice to find out who is listed as the attending.
 
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