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Code G0180 question

  1. Default Code G0180 question
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    From what I have seen from searching past forum discussions on this, it seems my Ortho surgeons can NOT bill Medicare patients for Care Plan oversight services (G0181) during a post op period but can they bill for the Care Plan certification (G0180)? Any help with this or links where I can find documentation on this?


  2. #2
    Use G0180 when certifying physician services for Medicare-covered services provided by a participating home health agency (where the patient is not present). This includes reviewing initial or subsequent reports of patient status, reviewing patient responses to an OASIS assessment, contacting the home health agency to ascertain the initial implementation of the care plan, and documentation in the patient's office record, per certification period.

    Use G0179 when recertifying home health agency patients.

    The initial certification code, G0180, must be used when patients have not received Medicare-covered home health services for at least 60 days. The recertification code, G0179, must be used when patients have received covered home health services for at least 60 days, and when the physician signs the certification after the initial certification.

    This came from the ACP website.

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