How To Use HCPCS Code G0515

HCPCS code G0515 describes the development of cognitive skills to improve attention, memory, and problem-solving through direct one-on-one patient contact. This code is used for compensatory training sessions that last for each 15 minutes. It is important for medical coders to understand the specific meaning and usage of this code in order to accurately assign it for billing and reimbursement purposes.

1. What is HCPCS G0515?

HCPCS code G0515 is used to identify the development of cognitive skills to improve attention, memory, and problem-solving through direct one-on-one patient contact. This code encompasses compensatory training sessions that are conducted for each 15 minutes. It is important to note that this code was terminated on December 31, 2019.

2. Official Description

The official description of HCPCS code G0515 is “Development of cognitive skills to improve attention, memory, problem-solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes.” The short description for this code is “Cognitive skills development.”

3. Procedure

1. The provider initiates the development of cognitive skills session by assessing the patient’s current cognitive abilities and identifying areas that need improvement.
2. Based on the assessment, the provider creates a personalized plan to target specific cognitive skills such as attention, memory, and problem-solving.
3. During the one-on-one session, the provider engages the patient in various activities and exercises designed to enhance cognitive skills.
4. The provider provides direct guidance and support to the patient throughout the session, offering feedback and reinforcement as needed.
5. Compensatory training techniques may be utilized to help the patient develop strategies to overcome cognitive challenges.
6. The session lasts for 15 minutes, and the provider documents the duration of the session in the medical record.

4. When to use HCPCS code G0515

HCPCS code G0515 should be used when a healthcare provider is conducting direct one-on-one sessions to develop cognitive skills in patients. These sessions aim to improve attention, memory, and problem-solving abilities. It is important to note that this code was terminated on December 31, 2019, so it should not be used for services provided after that date.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0515, healthcare providers should ensure that the following documentation requirements are met:

• Medical record documentation should include the patient’s cognitive assessment results, the personalized plan for cognitive skills development, and progress notes for each session.
• The duration of each session should be clearly documented in the medical record.
• Billing should accurately reflect the number of 15-minute sessions provided to the patient.

6. Historical Information and Code Maintenance

HCPCS code G0515 was added to the Healthcare Common Procedure Coding System on January 01, 2018. It had an effective date of January 01, 2020, and was terminated on December 31, 2019. The termination of this code indicates that it is no longer valid for billing and reimbursement purposes.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code G0515 is determined by carrier judgment (Coverage Code: C). It is important for healthcare providers to verify coverage with Medicare or other insurance carriers to ensure proper reimbursement. The pricing indicator code for this code is 11, which means the price is established using national RVUs (Relative Value Units). The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS is priced under one methodology.

8. Examples

Here are five examples of when HCPCS code G0515 should be billed:

1. A patient with attention deficit disorder (ADD) receives one-on-one cognitive skills development sessions to improve attention and problem-solving abilities.
2. An elderly patient with mild cognitive impairment undergoes compensatory training sessions to enhance memory and problem-solving skills.
3. A stroke survivor receives direct cognitive skills development sessions to regain and improve memory and problem-solving abilities.
4. A patient with traumatic brain injury (TBI) undergoes one-on-one cognitive skills development sessions to address attention and problem-solving deficits.
5. A child with learning disabilities receives compensatory training sessions to develop strategies for improving attention and problem-solving skills.