End of Life Counseling Billing Code?
I could really use your help. Had a patient just come in for "end of
life planning" only - AGAIN!!!! 2 days ago. I"m a little ticked at
scheduling. He tried to charge a 99213 and I told him it wouldn't fly.
Is there an End of Life Planning code, for billing? Dr says "I thought
that Congress approved this last year - please check with your coding
folks - it seems to me that there is a code."
Here's what I've found:
HCPC S0257 - "Counseling and discussion regarding advance directives or
end of life care planning and decisions, with paient and/or
surrogate(list separately in addition to code for appropriate evaluation
and management (E/M) service." However, it's not payable by Medicare.
My feeling is completion of these forms should addressed at the Annual
Wellness Vists (G0438 initial, G0439 estab); which Medicare now pays
for, effective January 1, 2011. It is considered part of that exam.
End of life planning is included as payable with Medicare, but only
under the Annual Wellness Visit (AWV) exam (physical exam) that they
began reimbursing for in 2011.
"The final version of the health-care legislation, signed into law by
President Obama in March, authorized Medicare coverage of yearly
physical examinations, or wellness visits. The new rule says Medicare
will cover "voluntary advance-care planning," to discuss end-of-life
treatment, as part of the annual visit."
"Under that proposal, doctors would have been able to bill Medicare
separately for advance-care planning consultations once every five
years, or when a patient's health changed dramatically. The plan also
suggested that physician performance could be measured in part by
whether patients had advance directives or living wills. Under heavy
fire, its authors stripped the provision out of the reform bill."
So, coders and billers out there, I'm looking for your take on this.
How should this be being billed?
I would appreciate your feedback. Thanks!
Melinda Brown, CMBS - Ins Biller
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