Wiki G0181

[jamie@beneficialmb.com]

Hello,

I'm having a little difficulty with Medicare regarding the G0181--on a few claims that I submitted, one or two came back paid but didn't have the required information that I found out you need on the claim. Does anyone know why some are being paid without the required information? Please help. Thank you.

 

[philipwells]

As opposed to G0180 and G0179, the only way I've gotten Medicare to cover
G0181 is when the to/from date on the claims spans the entirety of the month

example: 6/1/2015 - 6/30/2015

Sorry wish I was more help

 

[jamie@beneficialmb.com]

Hello,

I have figured it out. If the patient was not seen in the office for a visit within 6 months prior to billing the G0181, it will deny.

 

[philipwells]

Ahhhhh, thank you!

 

[ElizabethHarris]

Billing G0181/G0180

I work for a orthopedic practice, We were told by a home physical therapy vendor that we could bill G0180 or G0181 every 30 days for plan of care certification. This would be in the post op period for y for joint replacement surgery. Our understanding is that PCO is covered for the surgeon under the global period? Who is correct?