Results 1 to 9 of 9

CPO for Nursing Facility Patients

  1. #1
    Default CPO for Nursing Facility Patients
    Medical Coding Books
    This is a 3 part question:
    1. Our internal medicine doc supervises and signs off on certification/progress papers for nursing facility patients. What's the correct CPT code to bill for this service?
    2. What place of service is to be used?
    3. Does medicare pay for this service?

    Very stumped with this!
    Thanks for any help, I can get.

    JOGelico

  2. #2
    Default
    The Cpt codes you use are G0180 for Certify New plan of care $70.32 and G0179 for Recertification $54.23. You use 11 as the place of service. Medicare will pay for this service. Hope this helps.

    Karen

  3. #3
    Default
    Thanks for your answer but I thought those codes were used for supervision of home health agency patients??

  4. Default
    http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp

    Here is a link to the medicare fee schedule look up site

  5. #5
    Default
    Thanks got the Fee Schedule, but does anyone know what the correct codes are to use for the NF patient supervision?

  6. #6
    Default Care Plan Oversight NH, HH and Hospice
    I am trying to figure this out as well. 99374/99375, 99377/99378 and 99379/99380 are for CPO for home health patients, hospice patients and nursing facility patients respectively. But there is verbage that these codes SHOULD NOT BE REPORTED for supervision of patients in nursing facilities or under the care of home health agencies unless they require recurrent supervision of therapy. Then it goes on to state for care plan oversight services of patients in the home, domiciliary or rest home, see 99339/99340. But 99339/99340 states DO NOT REPORT 99339/99340 for patients under the care of a home health agency, enrolled in a hospice program or for nursing facility residents!!! So what do you use??? Then go to the HCPCS book and there is G0179, G0180, G0181 and G0182 that states for physician certification/re-certification for Medicare-covered home health services per cert/re-cert period and for supervision of home care/hospice patient so many minutes per calendar month. I am so confused???

    Any help would be greatly appreciated!!

    Thanks, Sue

  7. #7
    Default CPO/HHA Cert/re-cert
    I do billing for a group of physicians that go to the pt home and assisted living facilities. I bill G0179 for the physician signing the re-certification of home health services. I bill G0180 for the new certification.

    The supervision of a patient receiving services from a medicare approved home health agency or CPO -G0181 can be billed as long as you have the appropriate documentation to support.

    The supervision of a patient on hospice is G0182 and can only be billed by the "attending physician". The specific minutes only apply to the G0181 and the G0182. The new cert and re-cert G0179 and G0180 do not require a specific amount of time spent.

  8. Default
    Must the Assisted Living Facility have an NPI #?

  9. Default What POS should be used when submitting claims to commercial insurance (i.e UHC)
    UHC is denying CPT 99375 stating POS is invalid; my practices is using 11 as the provider is in his/her office doing the paper work because as you and I know the PT does not need to be present.....

    Help? any references I can use??

Similar Threads

  1. nursing home/ Medicare patients
    By astough in forum OB/GYN
    Replies: 1
    Last Post: 02-17-2012, 12:16 PM
  2. Nursing Home Patients Modifier??
    By erina586 in forum Modifiers
    Replies: 1
    Last Post: 12-05-2011, 04:44 PM
  3. Giving Botox to nursing home patients?
    By marci_ann in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 12-08-2010, 12:43 PM
  4. Nursing Home patients
    By dswords in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-21-2009, 02:48 PM
  5. Nursing Home CPO....Please help!
    By Cristy in forum E/M
    Replies: 3
    Last Post: 03-01-2009, 10:03 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.