We want to know the difference between "certification" G0180 and "supervision" G0181. MCR is not paying G0181 as not medically necessary. This is a confusing code. Any help would be appreciated..
Karen,
G0181 is
Care Plan Oversight, which is completely different from
Certifiications & Recertifications (G0180 & G0179).
G0181 requires complex or multidisciplinary care modalites involving:
* Regular physician development and/or revision of care plans;
* Review of subsequent reports of patient status;
* Review of related laboratory & other studies;
* Communication with other health professionals not employed in the same practice who are involved in the patient's care;
* Integration of new information into the medical treatment plan; and/or
* adjustment of medical therapy.
Care Plan Oversight Requirements:
* The provider who bills CPO must be the same provider who signed the plan of care.
* The provider may not have a financial or contractual relationship with the HHA.
* CPO may not be billed "incident-to"
* Providers billing for CPO must submit claim with no other services billed on that claim and may bill only
AFTER the end of the month in which the CPO services were rendered.
* CPO services may not be billed across calendar months and should be submitted and paid only for one unit of service.
I hope this helps?