Wiki G0556 and G0557

[korthmm20]

Does your practice bill for this service? Advanced primary care management services? It is very similar to chronic care management but, is not based on the time. My office is currently looking into trying to bill for this. We have a NP that visits local ALF/SNF facilities that we would like to use these codes with. Previously, we had a chronic care management program I did the coding/billing for but, we ended our program over a year ago.

I have information on the required consent, documents, etc. What I am looking for is general information on successful this was for you and how proper documentation was best kept track of (which is primarily our main concern). Any information related to your experience is much appreciated!

 

[Pam Warren]

I don't have any historical data; these are fairly new codes and we're just now in the process of implementing. What I will say is that there is no clear documentation guidance as to what needs to be in the chart on a monthly basis in order to report this service. This model is more about having the infrastructure in place and available to the patient, than it is an actual service to the patient. Many other services are bundled into these codes (CCM, TCM, etc.) so you have to make sure you don't unbundle.