How To Use HCPCS Code G0175

HCPCS code G0175 describes a scheduled interdisciplinary team conference with the patient present. This code is used to identify a specific type of service provided by healthcare professionals. In this article, we will explore the details of HCPCS code G0175, 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 G0175?

HCPCS code G0175 is used to identify a scheduled interdisciplinary team conference with the patient present. This conference involves a minimum of three healthcare professionals, excluding patient care nursing staff. It is an important part of patient care, as it allows healthcare professionals from different disciplines to come together and discuss the patient’s treatment plan, progress, and any necessary adjustments to ensure the best possible outcomes.

2. Official Description

The official description of HCPCS code G0175 is “Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present.” The short description for this code is “Opps service, sched team conf.”

3. Procedure

1. The healthcare provider schedules a team conference with a minimum of three healthcare professionals from different disciplines.
2. The conference is scheduled at a convenient time for all participants.
3. The patient is informed about the conference and invited to attend.
4. During the conference, the healthcare professionals discuss the patient’s treatment plan, progress, and any necessary adjustments.
5. Notes are taken during the conference to document the discussions and decisions made.
6. The conference may include discussions on medication management, therapy options, rehabilitation plans, and other aspects of the patient’s care.

4. When to use HCPCS code G0175

HCPCS code G0175 should be used when a scheduled interdisciplinary team conference is conducted with the patient present. It is important to note that this code is only applicable when a minimum of three healthcare professionals, excluding patient care nursing staff, are involved in the conference. This code should not be used for conferences without patient involvement or conferences with fewer than three healthcare professionals.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0175, healthcare providers need to ensure that the following documentation is included:

• Date and time of the conference
• List of healthcare professionals involved
• Notes documenting the discussions and decisions made during the conference
• Any relevant patient information discussed during the conference

It is important to accurately document the details of the conference to support the medical necessity of the service and ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0175 was added to the Healthcare Common Procedure Coding System on July 01, 2000. Since its addition, 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

HCPCS code G0175 is covered by Medicare and other insurance providers. 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 G0175 is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G0175 should be billed:

1. A patient with a complex medical condition requires input from a team of healthcare professionals, including a physician, nurse, and physical therapist, to discuss and coordinate their treatment plan.
2. A patient undergoing cancer treatment attends a conference with an oncologist, radiation therapist, and nutritionist to discuss their progress and make any necessary adjustments to their treatment plan.
3. A patient with a chronic illness attends a conference with a primary care physician, pharmacist, and social worker to discuss medication management, lifestyle modifications, and support services.
4. A patient recovering from a stroke participates in a conference with a neurologist, physical therapist, and speech therapist to evaluate their progress and develop a comprehensive rehabilitation plan.
5. A patient with a mental health condition attends a conference with a psychiatrist, psychologist, and social worker to discuss their treatment plan, therapy options, and any necessary referrals.