Monday, September 10, 2018

Advance Care Planning

CMS started paying for voluntary Advance Care Planning (ACP) from January 1, 2016.

ACP helps Medicare patients decide the plan of care that they would like to get when they are unable to take such decisions themselves.

Voluntary ACP is a face-to-face service between a physician (or other qualified health care  professional) and a patient discussing advance directives with or without completing relevant legal forms. An advance directive is a document in which a patient appoints an agent and/or records the  wishes of a patient pertaining to their medical treatment at a future time if they cannot decide for themselves at that time.

There are no limits on the number of times you can report ACP for a given patient in a given time period. When billing the service multiple times for a given patient, document the change in the patient's health status and/or wishes regarding their end-of-life care.

There are no place-of-service limitations on ACP services. You can appropriately furnish ACP services in facility and non-facility settings. ACP services are not limited to a 
particular physician specialty.

CMS requires no specific diagnosis to bill the ACP codes.

CPT 99497                
Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first  30 minutes, face-to-face with the patient, family member(s), and/or surrogate

CPT 99498      
Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)

Retrieved from https://www.medicare.gov/coverage/advance-care-planning.html

For more information refer the following link :  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AdvanceCarePlanning.pdf