Gastroenterology Coding Alert

Question: We have a patient who is eligible for home care, and our gastroenterologist is working out the details of a home care plan. Is that billable under any of the care plan oversight (CPO) codes?

Virginia Subscriber

Answer: No. Medicare does not consider time spent establishing the home health plan as billable. However, that doesn’t mean your provider can’t get paid for their time. You can report this time with a corresponding office/ outpatient evaluation and management (E/M) code, such as 99202-99215 (Office or other outpatient visit for the evaluation and management of a/an new/established patient, which requires a medically appropriate history and/or examination…).