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Neurosurgery Coding Alert

CPO Do's and Don'ts

Published on Tue Feb 10, 2004

If you're looking for "just the facts," here's a quick list of "Do's and Don'ts" to make your reporting of care plan oversight (CPO) easier.

Do
 

  • make sure the patient is receiving complex care requiring ongoing physician involvement.
     
  • be certain that the patient is receiving covered (home health agency, hospice or nursing facility) services during the CPO period.
     
  • provide and document at least 30 minutes of CPO for every calendar month during which you claim CPO payment.
     
  • make sure that the physician who bills for the CPO services is the same physician who furnished them.
     
  • document in the patient record which services the physician furnished, as well as the date and length of time of the services.
     
  • choose the correct CPO codes for your payer (99374-99380 for private insurers and G0179-G0182 for Medicare, depending on patient location/status)

    Don't

  • bill CPO for routine postoperative care the physician provides during a global surgical period.
     
  • bill for Medicare-covered hospice services if the physician is a medical director or employee of the hospice.
     
  • bill for Medicare-covered hospice services if the physician has a significant financial or contractual interest in the home health service.
     
  • bill for services provided "incident-to" a physician's service.
     
  • count travel time, phone calls to the patient's family, informal consults and conversations with other healthcare professionals, or hospital discharge services (99217 or 99238-99239) as a part of CPO.

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