tci General Surgery Coding Alert - 2002 Issue 9

Care Plan Oversight: Medicare Does It Differently

Medicare payers do not follow CPT guidelines for CPO and will not accept codes 99374-99380. Instead, Medicare designates HCPCS G codes G0181, which corresponds to CPT 99375, and G0182, which is equivalent to CPT 99377, to report CPO services. Medicare will not reimburse for CPO for patients in a skilled nursing facility (although it will pay for E/M visits). Also, Medicare will not reimburse for CPO services totaling less than 30 minutes per month because it considers these to be bundled to (i.e., included as part of or incidental to) other billable physician services. And Medicare requires that...

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