Neurology & Pain Management Coding Alert

Question: Is there any way we can bill for our neurologist's time, including transmitting the paperwork to the durable medical equipment (DME) supplier, when he prescribes a power wheelchair or scooter?


New York Subscriber


Answer: As of Oct. 25, 2005, you can report this service using HCPCS code G0372 (Physician service required to establish and document the need for a power mobility device).

This new code encompasses your physician's work preparing relevant parts of the patient's medical record for submission to the DME supplier. Use G0372 in conjunction with the appropriate evaluation and management code for the encounter that led to the power mobility device (PMD) prescription.
 
Time counts: For you to report G0372, the PMD supplier must receive the prescription and supporting documentation within 30 days of your physician's face-to-face encounter with the patient.

Medicare considers the time involved prescribing a  PMD equivalent to a level-one established patient visit, and reimburses the service accordingly. In 2006, you will collect about $20.62 for G0372 (based on 0.57 total non-facility relative value units), the same amount you would expect for 99211.