How To Use HCPCS Code G0239

HCPCS code G0239 describes therapeutic procedures that are performed to improve respiratory function or increase the strength and endurance of respiratory muscles in a group setting. This code includes monitoring of the procedure. In this article, we will explore the details of HCPCS code G0239, 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 G0239?

HCPCS code G0239 is used to identify therapeutic procedures that aim to improve respiratory function or increase the strength and endurance of respiratory muscles in a group setting. These procedures are typically performed by healthcare professionals who specialize in respiratory therapy. The code includes monitoring of the procedure to ensure its effectiveness and safety.

2. Official Description

The official description of HCPCS code G0239 is “Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)”. The short description of this code is “Oth resp proc, group”.

3. Procedure

1. The healthcare provider begins by assessing the respiratory function and muscle strength of each individual in the group.
2. Based on the assessment, the provider develops a customized treatment plan for each individual, focusing on improving respiratory function or increasing the strength and endurance of respiratory muscles.
3. The therapeutic procedures may include exercises, breathing techniques, use of respiratory devices, and other interventions aimed at achieving the desired outcomes.
4. During the group session, the provider closely monitors the participants to ensure proper technique, safety, and progress.
5. After the session, the provider may provide feedback and recommendations to each individual to continue their progress outside of the group setting.

4. When to use HCPCS code G0239

HCPCS code G0239 should be used when therapeutic procedures are performed in a group setting to improve respiratory function or increase the strength and endurance of respiratory muscles. This code is applicable when two or more individuals are receiving the same procedures simultaneously, and monitoring is included as part of the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0239, healthcare providers need to document the following:

• The number of individuals participating in the group session
• The specific therapeutic procedures performed
• The duration of the session
• The monitoring and assessment conducted during the session
• The progress and outcomes achieved

Providers should also ensure that the documentation supports medical necessity and justifies the use of group therapy rather than individual therapy.

6. Historical Information and Code Maintenance

HCPCS code G0239 was added to the Healthcare Common Procedure Coding System on January 01, 2002. It has an effective date of October 01, 2004. As of now, 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 therapeutic procedures performed under HCPCS code G0239. The pricing indicator code for this code is 11, which means the price is established using national Relative Value Units (RVUs). The multiple pricing indicator code is A, indicating that the code is not applicable as HCPCS is priced under one methodology.

8. Examples

Here are five examples of when HCPCS code G0239 should be billed:

1. A respiratory therapy group session consisting of five individuals, each receiving therapeutic procedures to improve their respiratory function.
2. A group session conducted in a rehabilitation center, where participants with respiratory conditions engage in exercises and techniques to increase the strength and endurance of their respiratory muscles.
3. A group session in a pulmonary rehabilitation program, focusing on improving the respiratory function of individuals with chronic lung diseases.
4. A group session in a fitness center, where individuals with respiratory limitations participate in specialized exercises to enhance their respiratory capacity.
5. A group session in a long-term care facility, where residents with respiratory conditions receive therapeutic interventions to maintain and improve their respiratory function.