# CPO for Nursing Facility Patients



## JOGelico (Mar 19, 2008)

This is a 3 part question:
1.   Our internal medicine doc supervises and signs off on certification/progress papers for nursing facility patients. What's the correct CPT code to bill for this service?
2.   What place of service is to be used?
3.   Does medicare pay for this service?

Very stumped with this!
Thanks for any help, I can get.

JOGelico


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## kmillsaps (Mar 26, 2008)

The Cpt codes you use are G0180 for Certify New plan of care $70.32 and G0179 for Recertification $54.23. You use 11 as the place of service. Medicare will pay for this service. Hope this helps.

Karen


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## JOGelico (Mar 28, 2008)

Thanks for your answer but I thought those codes were used for supervision of home health agency patients??


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## nlynch (Mar 28, 2008)

http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp

Here is a link to the medicare fee schedule look up site


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## JOGelico (Mar 28, 2008)

Thanks got the Fee Schedule, but does anyone know what the correct codes are to use for the NF patient supervision?


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## heycodinglady (Apr 17, 2008)

*Care Plan Oversight NH, HH and Hospice*

I am trying to figure this out as well.  99374/99375, 99377/99378 and 99379/99380 are for CPO for home health patients, hospice patients and nursing facility patients respectively.  But there is verbage that these codes SHOULD NOT BE REPORTED for supervision of patients in nursing facilities or under the care of home health agencies unless they require recurrent supervision of therapy.  Then it goes on to state for care plan oversight services of patients in the home, domiciliary or rest home, see 99339/99340.  But 99339/99340 states DO NOT REPORT 99339/99340 for patients under the care of a home health agency, enrolled in a hospice program or for nursing facility residents!!!  So what do you use???  Then go to the HCPCS book and there is G0179, G0180, G0181 and G0182 that states for physician certification/re-certification for Medicare-covered home health services per cert/re-cert period and for supervision of home care/hospice patient so many minutes per calendar month.  I am so confused???

Any help would be greatly appreciated!!

Thanks,  Sue


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## sophiaz8 (Apr 24, 2012)

*CPO/HHA Cert/re-cert*

I do billing for a group of physicians that go to the pt home and assisted living facilities. I bill G0179 for the physician signing the re-certification of home health services. I bill G0180 for the new certification. 

The supervision of a patient receiving services from a medicare approved home health agency or CPO -G0181 can be billed as long as you have the appropriate documentation to support.

The supervision of a patient on hospice is G0182 and can only be billed by the "attending physician". The specific minutes only apply to the G0181 and the G0182. The new cert and re-cert G0179 and G0180 do not require a specific amount of time spent.


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## ReneeGillam CPMA CMOM CMC (Jun 4, 2014)

Must the Assisted Living Facility have an NPI #?


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## mlmartin79 (Jul 17, 2014)

*What POS should be used when submitting claims to commercial insurance (i.e UHC)*

UHC is denying CPT 99375 stating POS is invalid; my practices is using 11 as the provider is in his/her office doing the paper work because as you and I know the PT does not need to be present.....

Help? any references I can use??


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## daedolos (Mar 16, 2020)

mlmartin79 said:


> *What POS should be used when submitting claims to commercial insurance (i.e UHC)*
> 
> UHC is denying CPT 99375 stating POS is invalid; my practices is using 11 as the provider is in his/her office doing the paper work because as you and I know the PT does not need to be present.....
> 
> Help? any references I can use??


What was your result? Did you follow through with this denial?

Peace
?_?


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