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G0317-G0319 help with what does visit mean?

pam powers

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I work for a nephrologist and do the esrd, mcp monthly billing on the physicians rounds of dialysis patients. my doctor and i are at a stand off as to what the medicare guidelines mean when they say, a face to face encounter with the dialysis pt". hoping someone might be able to help give more clairfacation on this. The codes are G0317, G0318, and G0319. i read as, the doctor must have a face to face visit with the patient while they are on dialysis and discuss the dialysis related issues the patient is having. help as i am at the end of my rope!!!!

thank you!
 
Last edited:

dabeall

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Face to Face time means that the physician must See the patient and talk with the patient while the patient is Dialysing. G0317 Means the physician must see the patient 4 or more times while the patient is dialysing. G0318 Means the physician must see the patient 2 To 3 times. G0319 means the physician must see the patient 1 time. This is during the same month. The physician cannot bill just because he is on the unit they must see the patient! If you have Trailblazer health as your Medicare contractor just go to their website and search for Dialysis services for part B and you can find all the info you need and have it in writing to show the physician. There are two different booklets available that map out the guidelines.:)
 

jenn13088

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I work for 8 nephrologist and oversee their monthly billing. As previously stated, the physician MUST see the patient face-to-face to fullfill the requirements of the G0317-G0319. There are several documentation requirements that also go along with these codes. Check your local Medicare contractor for the specifics. Another excellent resource is the Renal Physician's Association (RPA).

If you would like to talk to me, give me a call at 315-478-3311 ext. 123.

Jennifer
 
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