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Home Health Billing Help

  1. #1
    Melbourne, Florida
    Default Home Health Billing Help
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    Can I bill a Careplan Oversight G0181 to report the Certification and not G0179 Recert if it has been less than 60 days but the diagnoses have changed? Also if the new order is also within 45 days from the last Certification (billed G0181) but is now for Physical Therapy ordered by HOme Health/ or The Physical Therapist, can I bill for a cert G0181?

    Thanks! Any Help would be appreciated.
    Last edited by Pillow1; 10-22-2010 at 07:31 AM.
    Denise Gilrane-Pillow, CPB

  2. #2
    Dover Seacoast New Hampshire
    Was the patient re-admitted in the interim? if so, you can have a new re-certification within the 60 days, however we find that we have to appeal every single time, even though we eventually get paid. Otherwise, we have to wait the 60 days, even with a new diag.

    I'd clarify this with your Medicare contractor, just to be on the safe side. Contractors differ in their interpretation of the CMS rules.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. #3
    Melbourne, Florida
    Thank you, that helps, I haven't billed for Care Plan Oversight in over 10 years and misunderstood the definitions. It can be complicated. Thank you so very much for your very helpful response.
    Denise Gilrane-Pillow, CPB

  4. Default Careplan Oversights
    Hello All,

    I need help, period. I have never billed careplan oversights and need help understanding it and how to bill it. If anyone can help please let me know.

  5. Default Careplan oversights
    Hi, I bill for cert, recert and oversight quite often. What questions do you have? Or email me at and I'll answer any questions I can.

  6. #6
    Melbourne, Florida
    Default discharge for Home Health
    Is it incorrect to bill a dishcarge code (99217,99238 or 99239) for the home care discharge indicated on the discharge summary? I read the CMS coding information and it seems to support this. THank you again for everyone's feedback.
    Denise Gilrane-Pillow, CPB

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