Home Health & Hospice Week

Docs can enjoy flexibility when coding ACP.

In the 2016 Medicare Physician Fee Schedule proposed rule, the Centers for Medicare & Medicaid Services includes an example of how ACP services could occur in conjunction with treating or managing a patient’s presenting condition: A patient who is receiving treatment for heart failure and diabetes sees his physician for evaluation and management (E/M) of these two diseases.

Along with discussing short-term treatment options, the patient may want to discuss long-term

treatment options like a heart transplant. In this case, physicians would report a standard E/M code for the E/M service and one or both of the ACP codes depending on the duration of the ACP service.

Understand: The ACP services in this scenario would not necessarily need to occur on the same

day as the E/M service. This gives docs more flexibility to bill for ACP services, even when they provide E/M services on the same day as ACP services or during separate visits — or even during the patient’s annual Medicare-covered wellness visit, said American Academy of Family Physicians board chair Reid Blackwelder, MD, in a recent letter to CMS Acting Administrator Andy Slavitt.