How To Use HCPCS Code G0048

HCPCS code G0048 describes the provision of palliative care services to patients during the intake period through the end of the measurement year. This code is used to identify and bill for the specific services provided to patients who require palliative care.

1. What is HCPCS G0048?

HCPCS code G0048 is a specific code used in medical coding to identify and bill for palliative care services provided to patients. Palliative care is a specialized form of medical care that focuses on providing relief from the symptoms and stress of a serious illness. It is aimed at improving the quality of life for both the patient and their family.

2. Official Description

The official description of HCPCS code G0048 is “Patients who receive palliative care services any time during the intake period through the end of the measurement year.” The short description for this code is “Pall serv during meas.”

3. Procedure

1. The provider assesses the patient’s medical condition and determines the need for palliative care services.
2. A care plan is developed based on the patient’s specific needs and goals.
3. Palliative care services are provided to the patient, which may include pain management, symptom control, emotional support, and coordination of care.
4. The provider regularly evaluates the patient’s progress and adjusts the care plan as necessary.
5. Palliative care services continue throughout the intake period and the measurement year.

4. When to use HCPCS code G0048

HCPCS code G0048 should be used when a patient receives palliative care services during the intake period through the end of the measurement year. This code is applicable for patients who require palliative care to manage their symptoms and improve their quality of life.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0048, healthcare providers need to document the specific palliative care services provided to the patient. This documentation should include details of the services rendered, the duration of each service, and any relevant patient information. It is important to accurately code and document the services to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0048 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 other insurance providers may cover palliative care services billed under HCPCS code G0048. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G0048 should be billed:

1. A patient with advanced cancer receives palliative care services to manage pain and improve their quality of life.
2. An elderly patient with a chronic illness receives palliative care services to address their symptoms and provide emotional support.
3. A terminally ill patient receives palliative care services to ensure their comfort and dignity during their final days.
4. A patient with a progressive neurological condition receives palliative care services to manage their symptoms and provide support to their family.
5. A patient with end-stage heart failure receives palliative care services to address their symptoms and improve their overall well-being.