Pediatric Coding Alert

Question: Should I report care plan oversight services per month or per 30 days?


Florida Subscriber

 
Answer: You should tally minutes that the pediatrician spends on care plan oversight (CPO) on a monthly basis. CPO code descriptors (99374-99380) specify "within a calendar month," meaning October or November, etc. The number of days the month has, such as 30 or 31, doesn't matter.

For instance, your pediatrician sends home a newborn who requires home phototherapy that a home health agency (HHA) provides. The physician creates the care plan and supervises the agency's implementation and coordinates any changes as needed. Anytime she makes a phone call or writes a report regarding the patient's HHA supervision, she documents the time she spends on the item in the patient's chart. You tally the minutes accrued during October and come up with 35 billable minutes.

Report 99375 (Physician supervision of a patient under care of home health agency in home, domiciliary or equivalent environment requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, etc., within calendar month).

Pay attention: You can use 99375 for 30 minutes or more of documented CPO services. For 15-29 minutes, report 99374.