Home Health Coding & billing questions, HELP!!!


Tampa, Florida
Best answers
My physicians want to start billing for home health services. I was told by one of the home health agencies that we could use the recertification forms to bill for a Q0180. Is that correct? :confused:
I think the codes for Medicare are G0179 and G0180....the 179 is for re-cert and the 180 is for initial cert for HHA care.

Hope that helps....also, check your Medicare carriers website - they should have coverage information because these are a pain to get paid if you do not bill them exactly right.

Angela N. Andersen, CPC
Hi Guys,

I've billed Home Health/CPO in the past and didn't have too much trouble with it. The doctors I was billing for were pretty good about tracking the time spent involved in patient care (these codes are time-driven) & so it made my job a lot easier. I found the following article and it also further lists specific resources/publications from CMS that you should find very helpful.


Good Luck!

Question?? Do we use the diagnosis that the home health has listed on the initial plan with the G0180 code, or do we use our last primary diagnosis on file? This is my first time billing PCP claims, and I have a home health initial certification to bill out to Medicare....

Thank you!!

Kristie Stokes, CPC-A :)
Annie Shoffit, CPC

You use the diagnosis codes that home health gave you. They are supposed to listed in the same order that home health uses for their claim. Hope this helps!
I bill for HH inital certifications, G0180, to Medicare Palmetto GBA here in CA and I have no problem getting paid. Just make sure that your DX matches the first DX on the Plan of Care, your DOS should be the start of care date, POS must be 11 for office and the final thing is that you must put the HHA provider number in Box 23 (this is where prior auth numbers usually go) of the CMS 1500. The HHA provider number is in the upper right hand corner of the Plan of Care.
Our home health agency is telling the patient that Medicare does not put the G0180 to the patient's deductible nor their co insurance. FL medicare eobs that we have received state otherwise. Can someone please clarify that for us?