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G0180 Care Plan

  1. Cool G0180 Care Plan
    Medical Coding Books
    I am confused! Is G0180 ONLY billed to Medicare patients, or do all plans pay this?

  2. Default G0180
    I believe this would only be for Medicare patients. Typically G codes are for Medicare only. Some Medicare advantage plans may also accept this.

  3. Default
    Thank you so very much !!!

  4. Default
    Im having a bit of problem billing for this service, do you bill it on paper and enter the certification date in the shaded area on the cms1500 form or do you bill it electronically? If you bill it electronically where do you enter the certification date since the electronic claim form does not have the shaded area. Ive only billed one that was paid, i think that was just pure luck cause the others ive billed all came back denied. also i just started adding the last date the pcp saw the pt and the pcp npi. thanks for your help

  5. Default
    OK.. first you need to have a copy of the 485 Plan of Carre (initial treatment plan) in your chart. On the top line, far right, is the "Provider No." of the facility (6 digits). This is entered in block 23 of the CMS1500 form. The date oi service MUST be the "start of care" date, also on the top line of the 485 form. You MUST use the 1st diagnosis on the care plan (usually V54.81). Your place of service is office (11). I drop mine to paper as I haven't figured out how to get the computer to put the provider # in the right spot. Make sure also that blocks 29 and 30 are blank. Really simple once you do one. I have been paid for all of mine.

    PS. the PCP is never mentioned on the CMS1500. YOUR doctor's name goes on line 17 with his NPI. Nothing is in any shaded areas. The CMS1500 will look like an office visit with only the changes above. Remember, the G0180 is only used when the pt. goes directly home from the hospital and gets home care. Not used if they go to a SNF.
    Last edited by madgejones10; 11-08-2011 at 07:36 AM. Reason: adding

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