How To Use HCPCS Code G0046

HCPCS code G0046 describes a specific clinical follow-up and assessment procedure that is performed after an endovascular stroke intervention. This code is used when the Modified Rankin Scale (MRS) score is not assessed at 90 days following the intervention. In this article, we will explore the details of HCPCS code G0046, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0046?

HCPCS code G0046 is a specific code used to identify the clinical follow-up and assessment procedure that is performed after an endovascular stroke intervention. It is used when the MRS score is not assessed at 90 days following the intervention. This code helps healthcare providers accurately document and bill for this particular service.

2. Official Description

The official description of HCPCS code G0046 is “Clinical follow-up and MRS score not assessed at 90 days following endovascular stroke intervention.” The short description for this code is “No MRS 90 days post stk.”

3. Procedure

1. The provider should schedule a follow-up appointment with the patient after the endovascular stroke intervention.
2. During the follow-up appointment, the provider should assess the patient’s condition and progress.
3. The provider should document whether the MRS score was assessed at 90 days following the intervention.
4. If the MRS score was not assessed at 90 days, the provider should use HCPCS code G0046 to accurately report the service.

4. When to use HCPCS code G0046

HCPCS code G0046 should be used when the MRS score is not assessed at 90 days following an endovascular stroke intervention. It is important to accurately document and report this information to ensure proper reimbursement and tracking of patient outcomes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0046, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the endovascular stroke intervention
• Documentation of the follow-up appointment
• Documentation of the assessment of the patient’s condition and progress
• Documentation stating whether the MRS score was assessed at 90 days following the intervention

Providers should also follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0046 was added to the Healthcare Common Procedure Coding System on January 01, 2022. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G0046 may vary. It is important for healthcare providers to check with the respective payers to determine coverage and reimbursement policies. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, which indicates that the value is not established or the code is not priced separately by Part B.

8. Examples

Here are five examples of scenarios where HCPCS code G0046 should be billed:

1. A patient undergoes an endovascular stroke intervention, but the MRS score is not assessed at 90 days following the procedure.
2. After an endovascular stroke intervention, the patient fails to attend the scheduled follow-up appointment, resulting in the inability to assess the MRS score at 90 days.
3. A healthcare provider forgets to assess the MRS score at 90 days following an endovascular stroke intervention.
4. Due to unforeseen circumstances, the patient is unable to undergo the MRS assessment at 90 days following the endovascular stroke intervention.
5. The healthcare facility does not have the necessary resources or equipment to assess the MRS score at 90 days following the endovascular stroke intervention.