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g0180, and g0179

Mona Posted Fri 02nd of January, 2015 15:50:48 PM

medicare has been denying some of g0180 and g0179 by saying: Missing /incomplete/invalid HH certification Period? What does this mean? How can we correct it?

SuperCoder Answered Fri 02nd of January, 2015 23:59:02 PM

Thanks for your question. According to Medicare, the certification code for a home health agency is valid when the patient starts a new episode of home health care and the patient hasn't received any home health services covered by Medicare in the last 60 days. The re-certification code is used after the patient has received home health services for at least 60 days and when the physician certifies that the patient needs to continue home health services. There is no special form that the certification or re-certification needs to be completed on. The claims will pay as long as Medicare determines that the requirements for certification have been met. G0179 will deny when billed more than once in a 60 day period. See the attached link for additional information on certification requirements.

http://www.wpsmedicare.com/j5macpartb/resources/provider_types/cert-recert-covered-hhs.shtml

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