How To Use HCPCS Code G0501

HCPCS code G0501 describes resource-intensive services for patients who require the use of specialized mobility-assistive technology during an office/outpatient evaluation and management visit. These services are deemed medically necessary and are used to enhance patient comfort and accessibility. In this article, we will delve into the details of HCPCS code G0501, 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 G0501?

HCPCS code G0501 is used to identify resource-intensive services provided to patients who require the use of specialized mobility-assistive technology during an office/outpatient evaluation and management visit. This code is used to indicate that additional resources, such as adjustable height chairs or tables, patient lifts, and adjustable padded leg supports, were necessary to accommodate the patient’s needs during the visit.

2. Official Description

The official description of HCPCS code G0501 is “Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service).” The short description for this code is “Resource-inten svc during ov.”

3. Procedure

1. During the office/outpatient evaluation and management visit, the healthcare provider assesses the patient’s medical condition and determines the need for specialized mobility-assistive technology.
2. If it is determined that the use of specialized mobility-assistive technology is medically necessary, the provider ensures that the appropriate equipment, such as adjustable height chairs or tables, patient lifts, and adjustable padded leg supports, is available.
3. The provider then utilizes the specialized mobility-assistive technology to enhance the patient’s comfort and accessibility during the visit.
4. Throughout the visit, the provider documents the use of the specialized mobility-assistive technology and any relevant details regarding its impact on the patient’s care.

4. When to use HCPCS code G0501

HCPCS code G0501 should be used when a patient requires the use of specialized mobility-assistive technology during an office/outpatient evaluation and management visit. This code is specifically for resource-intensive services and should be listed separately in addition to the primary service provided. It is important to ensure that the use of the specialized mobility-assistive technology is medically necessary and enhances the patient’s ability to receive care.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0501, healthcare providers should ensure that the use of specialized mobility-assistive technology is clearly documented in the patient’s medical record. This documentation should include details about the specific equipment used, the duration of its use, and any impact it had on the patient’s care. Additionally, the code should be listed separately in addition to the primary service provided during the office/outpatient evaluation and management visit.

6. Historical Information and Code Maintenance

HCPCS code G0501 was added to the Healthcare Common Procedure Coding System on January 01, 2017. 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. This code is still currently active and can be used for billing resource-intensive services involving specialized mobility-assistive technology.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G0501 may vary depending on the carrier’s judgment. It is important to check with Medicare and other insurance providers to determine their specific coverage policies for this code. The pricing indicator code for G0501 is 13, which means that the price for this service is established by carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS is priced under one methodology. Providers should verify the reimbursement rates with the respective payers.

8. Examples

Here are some examples of scenarios in which HCPCS code G0501 should be billed:

1. A patient with limited mobility requires the use of an adjustable height chair during their office visit to ensure their comfort and accessibility.
2. A patient with mobility challenges needs the assistance of a patient lift to safely transfer them from their wheelchair to the examination table during their evaluation and management visit.
3. A patient with leg impairments requires the use of adjustable padded leg supports to maintain proper positioning and support during their office/outpatient visit.
4. A patient with a complex medical condition necessitates the use of multiple specialized mobility-assistive technologies, such as adjustable height chairs, patient lifts, and adjustable padded leg supports, to ensure their comfort and safety during their evaluation and management visit.
5. A patient with a temporary injury requires the use of specialized mobility-assistive technology, such as adjustable height chairs or tables, to accommodate their limited mobility during their office/outpatient visit.