How To Use HCPCS Code G0024

HCPCS code G0024 describes principal illness navigation services that require an additional 30 minutes per calendar month. This code is used to identify and bill for the additional time spent by healthcare providers in assisting patients with navigating through the healthcare system. It is important for medical coders to understand the specific meaning and usage of this code in order to accurately report and bill for these services.

1. What is HCPCS G0024?

HCPCS code G0024 is used to identify principal illness navigation services that require an additional 30 minutes per calendar month. These services are provided to patients who need assistance in navigating through the healthcare system due to their principal illness. The additional 30 minutes of navigation services are provided on top of the initial navigation services provided under HCPCS code G0023.

2. Official Description

The official description of HCPCS code G0024 is “Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to G0023).” The short description for this code is “Pin srv add 30 min pr m.”

3. Procedure

1. Healthcare providers offering principal illness navigation services under HCPCS code G0024 should first assess the patient’s specific needs and requirements.
2. Providers should then develop a personalized navigation plan for the patient, taking into consideration their principal illness and any specific challenges they may face in accessing healthcare services.
3. During the navigation session, providers should assist the patient in scheduling appointments, coordinating referrals, and obtaining necessary authorizations for medical procedures or treatments.
4. Providers should also help patients understand their healthcare options, including available providers, facilities, and treatment options.
5. Throughout the navigation process, providers should document the services provided, including the duration of each session and the specific tasks performed.
6. Providers should ensure that the additional 30 minutes of navigation services are clearly documented and billed separately from the initial navigation services provided under HCPCS code G0023.

4. When to use HCPCS code G0024

HCPCS code G0024 should be used when healthcare providers provide an additional 30 minutes of principal illness navigation services per calendar month. These services are specifically for patients with a principal illness who require extended assistance in navigating through the healthcare system. It is important to note that this code should only be used in addition to the initial navigation services provided under HCPCS code G0023.

5. Billing Guidelines and Documentation Requirements

When billing for principal illness navigation services under HCPCS code G0024, healthcare providers should ensure that the following guidelines and documentation requirements are met:

• Accurately report the duration of the additional 30 minutes of navigation services provided.
• Clearly document the tasks performed during the navigation session.
• Bill for HCPCS code G0024 separately from the initial navigation services provided under HCPCS code G0023.
• Include any necessary supporting documentation, such as progress notes or care plans, to substantiate the medical necessity of the services provided.

6. Historical Information and Code Maintenance

HCPCS code G0024 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of its addition, there have been no maintenance actions taken for this code. The code has an effective date of January 01, 2024, and is currently active for use in medical coding and billing.

7. Medicare and Insurance Coverage

HCPCS code G0024 is subject to carrier judgment when it comes to Medicare coverage. The pricing indicator code for this code is 13, which indicates that the price for this service is established by carriers. The multiple pricing indicator code is A, indicating that the code is not applicable as HCPCS priced under one methodology. It is important for healthcare providers to check with Medicare and other insurance carriers regarding coverage and reimbursement policies for principal illness navigation services under HCPCS code G0024.

8. Examples

Here are some examples of scenarios where HCPCS code G0024 should be billed:

1. A patient with a chronic illness requires assistance in scheduling and coordinating multiple specialist appointments. The healthcare provider spends an additional 30 minutes per month helping the patient navigate through the healthcare system to ensure timely and appropriate care.
2. A patient with a complex medical condition needs guidance in understanding their treatment options and obtaining necessary authorizations for specialized tests. The healthcare provider dedicates an additional 30 minutes per month to assist the patient in navigating through the healthcare system.
3. A patient with a principal illness requires ongoing support in coordinating home healthcare services. The healthcare provider spends an additional 30 minutes per month helping the patient navigate through the process of obtaining and managing home healthcare services.
4. A patient with a serious illness needs assistance in understanding their insurance coverage and accessing appropriate financial resources for their medical expenses. The healthcare provider dedicates an additional 30 minutes per month to provide guidance and support in navigating through the complex insurance and financial systems.
5. A patient with a terminal illness requires assistance in coordinating end-of-life care and accessing hospice services. The healthcare provider spends an additional 30 minutes per month helping the patient and their family navigate through the process of transitioning to hospice care.