Pulmonology Coding Alert

Question: The pulmonologist traveled 45 minutes to a team meeting as part of care plan oversight (CPO) for a hospice Medicare patient. During a 22-minute interdisciplinary team meeting about the patient, the pulmonologist revises the care plan and reviews recent lab results. The pulmonologist then spends 10 minutes adjusting the patient's medical therapy and directing the hospice nurse on the changes, and another six minutes on the phone with the pharmacy ordering medication for the patient. Does this encounter meet Medicare's CPO time minimum?

Michigan Subscriber

Answer: This meets Medicare's 30-minute minimum for CPO codes -- but just barely.

When counting total CPO time, be aware of the tasks that Medicare does not count toward CPO time. Medicare does not count travel time or the time the physician spends phoning in prescriptions toward CPO. Therefore, you cannot count the 45 minutes of travel or the six minutes on the phone.

However, you can count the time the pulmonologist spent in the team meeting, revising the care plan and analyzing lab results (22 minutes), and the time spent adjusting the patient's medical therapy and advising the hospice nurse (10 minutes). Those two tasks total 32 minutes, just above the 30-minute minimum necessary for CPO reporting.

Summary: On the claim, report G0182 (Physician supervision of a patient under a Medicare-approved hospice [patient not present] requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans ...) for the service.