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Hospice Certification and Plan of Tx

Guna Posted Mon 12th of January, 2015 04:43:25 AM

What are the CPT codes are using for Medicare Hospice Certification?

SuperCoder Answered Mon 12th of January, 2015 09:06:08 AM

Thanks for your question. The appropriate procedure codes to bill to Medicare for hospice certification are G0180 and G0179.

G0180; Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per certification period

G0179; Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per re-certification period

According to CMS, you would bill G0180 when the patient has not received any home health or hospice related services in the last 60 days and you would bill G0179 after a patient has received services for the last 60 days but needs re-certification. See attached link for additional information.

https://www.supercoder.com/coding-newsletters/my-part-b-coding-alert/home-care-dont-be-afraid-to-bill-g0179-and-g0180-for-home-care-certsrecerts-article

Guna Posted Tue 13th of January, 2015 03:49:54 AM

Thanks for your reply. Then tell me when we can report CPT G0181 and G0182, I think CPT G0182 is a code for Medicare-approved Hospice care, please correct me if I'm wrong.

SuperCoder Answered Tue 13th of January, 2015 16:30:52 PM

You would use G0181 for physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more.

G0182 would be billed for physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more.

Basically G0181 is billed for supervision of home health patients and G0182 is billed for supervision of hospice patients. See the attached link for additional information.

https://www.supercoder.com/coding-newsletters/my-oncology-hematology-coding-alert/get-paid-for-case-management-with-g0181-and-g0182-article

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