Top 10 Tips for Using Advance Care Planning Codes in Palliative Medicine and Beyond.
Although recommended for all persons with serious illness, advance care planning (ACP) has historically been a charitable clinical service. Inadequate or unreliable provisions for reimbursement, among other barriers, have spurred a gap between the evidence demonstrating the importance of timely ACP and recognition by payers for its delivery.1For the first time, healthcare is experiencing a dramatic shift in billing codes that support increased care management and care coordination. ACP, chronic care management, and transitional care management codes are examples of this newer recognition of the value of these types of services. ACP discussions are an integral component of comprehensive, high-quality palliative care delivery. The advent of reimbursement mechanisms to recognize these services has an enormous potential to impact palliative care program sustainability and growth. In this article, we highlight 10 tips to effectively using the new ACP codes reimbursable under Medicare. The importance of documentation, proper billing, and nuances regarding coding is addressed.
1 Main Line Health , Radnor, Pennsylvania.|2 Lankenau Medical Center , Wynnewood, Pennsylvania.
Christopher A
CA
Jones
3 Acevedo Consulting, Inc. , Delray Beach, Florida.
Jean
J
Acevedo
4 Four Seasons Compassion for Life , Flat Rock, North Carolina.
Janet
J
Bull
5 Duke Palliative Care , Durham, North Carolina.|6 Duke Cancer Institute , Durham, North Carolina.
Arif H
AH
Kamal
D032722:Advance Care Planning; D006801:Humans; D006278:Medicare; D010166:Palliative Care; D065126:Palliative Medicine; D012051:Reimbursement Mechanisms; D014481:United States
advance care planning; billing and coding; community-based palliative care; inpatient palliative care; outpatient palliative care; revenue
Can J Nurs Adm. 1997 May-Jun;10(2):96-108
9384018
JAMA. 2000 Mar 15;283(11):1437-44
10732933
J Health Polit Policy Law. 2015 Oct;40(5):1087-101
26195604
J Palliat Med. 2015 Mar;18(3):211-6
25671789
Palliat Med. 2016 Mar;30(3):224-39
26405109