HCCIntelligence™ Webinar Recording: The Most Important Billing Codes You May Not Be Using

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The webinar and virtual office hours held on June 19, 2019, by the Home Centered Care Institute (HCCI) focused on crucial billing codes that practitioners may be underutilizing in home-based primary care (HBPC). Hosted by Brianna Plencner, CPC, CPMA; Thomas Cornwell, MD; and Paul Chiang, MD, the session aimed to cover several objectives:<br /><br />1. Identifying often overlooked opportunities to enhance reimbursement.<br />2. Describing coding and documentation requirements for various services including advance care planning, prolonged non-face-to-face services, anticoagulation management, and home health certifications/recertifications.<br />3. Maximizing revenue by proper coding and billing for services already being provided.<br /><br />Advance Care Planning (ACP) was a key focus. ACP involves a physician or qualified healthcare professional having a face-to-face discussion with a patient about advance directives, and it can be billed by various healthcare providers like physicians, nurse practitioners, and physician assistants. ACP can be billed multiple times with significant changes in the patient's health and requires meticulous documentation of time spent and details of discussions, which must be voluntary and documented in the medical record.<br /><br />Prolonged services before and/or after direct patient care (Non-F2F) were also highlighted. CPT codes 99358 and 99359 are used for these services, which need to be time-based and over the usual time spent on an E/M service, with specific documentation required for billing.<br /><br />Anticoagulation management services have two relevant CPT codes: 93792 for the initial setup and 93793 for review and management of ongoing tests. These services often involve patient or caregiver training and cannot be billed alongside chronic or transitional care management services.<br /><br />Additionally, proper coding for home health certifications (G0180) and recertifications (G0179) was discussed, emphasizing the requirements for documentation and the interaction with the home health agency.<br /><br />Finally, potential additional billing opportunities were outlined, including Chronic Care Management, Transitional Care Management, Care Plan Oversight, Behavioral Health Integration Services, Cognitive Assessment & Care Planning, Smoking Cessation Counseling, and Brief Communication Technology Virtual Check-ins. The webinar encouraged the use of these codes to enhance practice revenue, with emphasis on rigorous documentation and compliance with CMS guidelines.

Keywords

Home Centered Care Institute

billing codes

home-based primary care

Advance Care Planning

prolonged non-face-to-face services

anticoagulation management

home health certifications

reimbursement

CPT codes

documentation requirements