Oncology & Hematology Coding Alert

Question: Our oncologist has been supervising the care of a hospice patient with brain cancer (191.1, Malignant neoplasm of brain; frontal lobe). How should I code for this?

North Carolina Subscriber

Answer: If the patient is non-Medicare, report care plan oversight (CPO) codes 99377 (Physician supervision of a hospice patient [patient not present] requiring complex and multidisciplinary care modalities within a calendar month; 15-29 minutes) or 99378 ( 30 minutes or more). For Medicare patients who require complex, recurrent care and reside in a home health agency, use G0181 (Physician supervision of a patient receiving Medicare-covered services provided by a participating home health agency [patient not present] requiring complex and multidisciplinary care modalities within a calendar month, 30 minutes or more) or G0182 (formerly 99378) ( a Medicare- approved hospice) for a hospice patient.
 
Medicare will not reimburse CPO services that are less than 30 minutes or that are performed in a nursing facility. CMS doesnt consider a private, attending physicians professional services that are reasonable and necessary for the treatment and management of a hospice patients terminal illness to qualify as hospice services. You may bill these services to your Medicare Part B carrier, provided a physician not under a payment arrangement with the hospice furnishes the services. In addition, to bill for hospice care, your oncologist must directly supervise the patients treatment. Make sure, for example, that your physician doesnt bill for answering the hospice medical directors or supervising physicians questions over the telephone.