As of Nov. 1, 2015 you are required to record the start and end time for a prolonged counseling visit (0120 series) in the patient’s medical record, and to submit those times with your billing claim to MSP. This change was made in order to protect GPs in the case of audit.
We know that many of you feel swamped by paperwork, including documentation requirements for fees. However, the change is considered necessary in order to protect GPs in the case of audit. Medical inspectors look for documentation to support the billing criteria for any fee, and in the case of the 0120, there is a requirement for a minimum of 20 minutes. Requiring start/end times to be submitted and recorded for the 0120 series brings the fees into line with the GPSC Mental Health Management fees (14044-14048) which have the same requirements.
SGP has heard from some members that when they “google” CSHA frailty score, they find information on scores of 6 and 7 that seems to contradict that found in the description of fee code 14075. GPSC uses the scale contained in the GPAC guideline Frailty in Older Adults, revised January 2012. When you click on the links embedded in the SGP website, you are directed to the scale as it appears in the GPAC guideline, and you may rely on that.
On August 1, 2015 the General Practitioner Services Committee (GPSC) made revisions to the wording of some GPSC fees. Simplification of documentation requirements for the complex care fee were made Sept. 18.
Here are some of the key points:
1) There is no longer a requirement to give flowsheets to patients. Offer self-management supports as appropriate for individual patients.
GPSC notes: “Must have chart-documented provision of a clinically appropriate level of guideline-informed care in the preceding year, including patient self-management supports as appropriate for individual patients. Sharing of flow sheets no longer required, although the use of flow sheets (paper or electronic) as a tool for documentation is still considered an appropriate confirmation of care provision.”
2) For annual billing of CDM incentives, one of the two visits required in the preceding year can be a GPSC telephone visit or a group medical visit.
GPSC notes: “There must be at least 2 visit fees (office; prenatal; home; long term care; only one of which can be a GPSC Telephone Visit or a Group Medical Visit) in the 12 months prior to billing the CDM incentive. Visits provided by a locum are included; however, if the 2-visit requirement includes a locum visit, an electronic note must be submitted with the claim.”
3) Start and end times are now required for billing submission for mental health planning fees (14043) , palliative planning fees (14063) and mental health management fees (14044, 14045, 14046, 14047, 14048). The start and end times should also be recorded in the chart.
GPSC notes: “Minimum requirement of 30 minutes face-to-face time in addition to visit time (home/office) same day. Both chart and claim must state start and end times of the total service (planning + visit).”
4) For the Complex Care Planning fees 14033 and 14075, the chart note must include the total of : time spent planning (face-to-face, chart review and documentation) plus time spent for the required same day visit fee. Of this total, the majority must be face-to-face, and this majority time must also be charted.
GPSC notes: “Minimum required time 30 minutes to review chart and create the care plan jointly with the patient and/or their medical representative. The majority of the time must be face-to-face. Documentation in the patient chart of total time spent in planning (face to face; review) and medical visit is required.”
So, document a minimum of 35 minutes of total work time for the combined visit and planning.
The 35 combined minutes should include:
- at least 20 minutes of physician-patient face-to-face time
- plus any combination of:
- chart review
- more physician-patient face-to-face time
- encounter documentation
- allied care provider time with patient
For example: You spend 20 minutes face to face with the patient and 15 minutes on chart review and documentation.
Document: total time = 35 min, face to face time = 20 min
5) GP’s on Alternate Payment who bill encounter codes are now requested to use a different set of CDM codes when submitting for these services.
GPSC notes: “New codes for GPs who bill encounter codes are available retroactively to January 1, 2015. Please wait until after August 4, 2015 to resubmit any rejected CDMs with these new codes retroactively. Submission code “A” may be used for any claims over 90 days of age. The 2-visit requirements are subject to review of encounter codes to confirm provision of care.”
For the full details read GPSC’s summary of the changes.
SGP is interested to hear what you think of the GPSC’s changes. Send us your thoughts at: email@example.com
The SGP Board provided the following feedback to the Doctors of BC policy consultation process about the Ministry of Health Primary Care Policy Papers
SGP Board Response to Primary Care Policy Paper 2015
You can read the Ministry policy papers here
Send us your thoughts at SGP.Feedback@doctorsofbc.ca
SGP has posted updated uninsured services invoices with NEW rates for 2015 in the uninsured services package section of our website.
We have updated the Worksafe page of the SGP website to reflect the following changes:
Effective January 26, 2014: fee codes for submitting Form 8 and 11 have been simplified. Merely select the fee code matching which report form you are submitting (Form 8 or Form 11), and the method of your submission (electronic via Teleplan or non-electronic via fax or mail). It is no longer necessary to select a fee code that matches the timeliness of your submission. The timeline is determined automatically by WorkSafeBC.
Effective March 12, 2015: fee codes 19938, 19901, 19941, and 19903 will be obsolete. If the physician is invoicing electronically through Teleplan, the fee codes will not be an option in their invoicing software; they will have disappeared following update from MSP. If the physician is invoicing by fax or mail, the item will be rejected and the physician must resubmit the invoice using the correct fee code.
See WCB’s summary: New WorksafeBC Fee code changes
Check out more SGP Billing Tips in our Billing Tip Archive
You can read the primary-and-community-care-policy-paper or go to their library to read all 4 papers released Feb. 18: Delivering a Patient Centred, high performing and sustainable health system; Surgical Services; Rural Health Services and the primary care paper.
The FP/GP privileging dictionary work is ready for final feedback. Read it @ family-medicine-privileges- SGP is interested to hear feedback at firstname.lastname@example.org Colleagues representing the broad spectrum of family medicine work- urban, suburban and rural- have worked collaboratively to write the dictionary which will be implemented province wide for hospital privileging in Family Medicine. Organizations involved in the process included BCCFP; CFPC; Health Authorities; SGP; Doctors of BC; and Rural Issues Committee. Read more information on the Provincial Privileging Project @ www.privileging.typepad.com
G14019 NEW – GP-Nurse Practitioner Advice Fee Code $40.00
Billable by a family physician for providing advice to a nurse practitioner (NP), in cases where the NP requesting advice is the Most Responsible Provider for a patient’s care in the community.
If providing advice to an NP about a patient for whom you are the MRP (Most Responsible provider), see fee code: G14077.
Read more about 14019 NEW – GP-Nurse Practitioner Advice Fee Code.
Read more about All Case Conferencing Fee Codes,
Doctors of BC has released a new policy paper on Telemedicine in Primary Care.