G0180 billed by 2 different providers

mtsoldevila

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McKinney, TX
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I billed G0180 to Medicare and was denied for "payer deems the information provided does not support these many services". I called Medicare and they told me that another doctor has billed this code already. Does G0180 can only be billed once within the first 60 days even when both providers are from different specialties?
 

thomas7331

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G0180 is for the physician's work of completing the paperwork necessary for the home health agency to certify the medical necessity of their services. If two physicians are billing this, then they are not coordinating their care and are duplicating each other's work since the patient can only have one home health agency at a time, as I understand it. You might want to speak with the home health agency and see if you can get this straightened out so it doesn't happen again - they shouldn't be asking multiple providers to certify. Or it may be the case that the other provider has billed that code in error for something they didn't do?
 

mtsoldevila

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McKinney, TX
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G0180 is for the physician's work of completing the paperwork necessary for the home health agency to certify the medical necessity of their services. If two physicians are billing this, then they are not coordinating their care and are duplicating each other's work since the patient can only have one home health agency at a time, as I understand it. You might want to speak with the home health agency and see if you can get this straightened out so it doesn't happen again - they shouldn't be asking multiple providers to certify. Or it may be the case that the other provider has billed that code in error for something they didn't do?
thank you. I will reach out to the HH agency.
 
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