Oncology & Hematology Coding Alert

Question: In your May Oncology Coding Alert, you stated that you may assign certification code G0180 only when a physician has not provided Medicare-covered home health services to the patient for at least 60 days. But what if the physician provided the services but we billed the patient's private carrier, not Medicare? Would this service still fall under this guideline?

Illinois Subscriber

Answer: Yes, Medicare's guidelines for G0180 (Physician certification for Medicare-covered home health services under a home health plan of care [patient not present] ... per certification period) still apply in this instance. All Medicare providers, whether participating or non-participating, must bill Medicare for all services rendered. In other words, there is no difference in your billing or coding for this service because the original ruling is applicable under the Medicare guidelines.

- Answers to Reader Questions and You Be the Coder were provided by Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.