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Level 1 APCM diagnosis coding

S

srandolph11

New
Local Chapter Officer
Messages
7
Location
Park City, KS
I'm hoping to find someone who has some experience with billing APCM codes. More specifically how they bill a level 1 APCM (G0556).
A scenario - If there is no clear dx, is it possible to use a Z code from Z00-Z13 for the visit?
 
srandolph11 said:
I'm hoping to find someone who has some experience with billing APCM codes. More specifically how they bill a level 1 APCM (G0556).
A scenario - If there is no clear dx, is it possible to use a Z code from Z00-Z13 for the visit?
Click to expand...
We have been billing APCM since 2025, when the codes were released. We do not enroll anyone unless they have at least 1 chronic condition. A chronic condition is expected to last more than 12 months or until death. Why was the patient enrolled in APCM? When we bill G0556, G0557, or G0558, we use the diagnoses that are associated with their care plan.
 
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