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G0179, G0180 and G0181

Suhel Posted Thu 23rd of February, 2012 22:09:32 PM

In order to bill for managing patients in home health care, I would use code G0180 for initial certification, and G0179 for each re-certification. Then when exactly do i use G0181? I was told that I cannot use this code for the month in between the certification month and re-certification month. Is this correct? Please Advise. Thank you in advance

SuperCoder Answered Fri 24th of February, 2012 07:28:38 AM

Hi Siddiqui:

Patients are eligible to receive CPO services if they require complex treatment, are being cared for by multidisciplinary teams and are under the care of a Medicare-approved home health agency or hospice.
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For example, a family physician sees an elderly patient with diabetes who lives alone and has nonhealing skin ulcers. The patient is enrolled in and receiving services from a home health agency, and the physician signs the initial plan of care. Over the course of the month, the physician coordinates care with the agency's nursing staff, arranges for treatment at a wound clinic and talks to the treating physician there, reviews multiple lab results not related to an office visit or another E/M service, and adjusts the patient's medications. The physician spends more than 30 minutes during the month doing these activities, documents the dates, times and services, and bills G0181.
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Another example is medical care for a patient undergoing chemotherapy for colon cancer. The family physician signs the plan of care, certifying the patient for home health services, and provides an E/M service. During the course of the month, the physician discusses the patient's care with the oncologist, manages the patient's pain, arranges for nutrition services and interacts with the home health agency staff. Over the course of the calendar month, if the physician spends more than 30 minutes in these activities and documents the services, dates and times, then G0181 can be billed.
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So for all this information refer this link: http://www.aafp.org/fpm/2005/0500/p23.html
Also refer this link how to bill: http://www.unityhomecare.com/Employees/Forms/INSTRUCTION/PHYSICIAN/CPO-Cert-Recert-Presentation.pdf

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