# Home Health CPO G0180 denial ??



## mgord (Oct 31, 2013)

We have received several of these claims back from Cahaba. Has something changed recently in regards to physician reimbursement of G0180 that maybe I am not aware of?

One patient was denied with M97 and we were told that this was because the patient was inpatient on the date we billed. This certification date was 07/23/13 through 09/03/13 but the doc didnt sign until 08/12/13 - which is the date we used as the DOS. The patient just happened to be in the hospital on this date and Cahaba says the payment is bundled to ???? We did not even see this patient during this admission. 

The other patient denied M25. 
I am lost as last years Easter egg on these because this is the first time I've ever been made aware that Medicare denied the G0180. 
Any help/clarification would be greatly appreciated. 
Thanks!


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## Kisalyn (Nov 4, 2013)

You'll probably have to appeal the inpatient case. On the other ones, are they requesting records? They might be checking to see if there's documentation of the face-to-face that needs to occur 90 days prior to the certification or 60 days after and whether the documentation of the face to face is good enough.


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## tdml97@yahoo.com (Nov 4, 2013)

The one that was in the hosp, I would change the date to 7/23 - should go thru.

Do not understand the second one - need more detail on denial.


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