How To Use HCPCS Code G2008

HCPCS code G2008 describes a moderate (45 minutes) in-home visit for an existing patient post-discharge. This code is specifically used in a Medicare-approved CMMI model and is intended for services provided within a beneficiary’s home, domiciliary, rest home, assisted living, and/or nursing facility within 90 days following discharge from an inpatient facility. It should be noted that this code can only be used up to 9 times.

1. What is HCPCS G2008?

HCPCS code G2008 is used to identify a specific type of in-home visit for an existing patient who has been discharged from an inpatient facility. The visit is considered moderate in length, lasting approximately 45 minutes. It is important to note that this code is only applicable in a Medicare-approved CMMI model.

2. Official Description

The official description of HCPCS code G2008 is “Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model.” The short description is “Post-d/c h vst ext pt 45 m.”

3. Procedure

1. The provider begins by scheduling an in-home visit with the existing patient who has been discharged from an inpatient facility within the past 90 days.
2. During the visit, the provider assesses the patient’s condition and addresses any concerns or issues related to their post-discharge care.
3. The provider may perform various tasks such as reviewing medications, monitoring vital signs, providing wound care, or assisting with activities of daily living.
4. The visit typically lasts for approximately 45 minutes, allowing the provider enough time to thoroughly evaluate the patient’s progress and address any necessary interventions.
5. Documentation of the visit should include a detailed description of the services provided, the patient’s response to treatment, and any recommendations for further care or follow-up.

4. When to use HCPCS code G2008

HCPCS code G2008 should be used when an existing patient requires a moderate in-home visit following their discharge from an inpatient facility. The visit must take place within 90 days of the patient’s discharge and should be provided within a beneficiary’s home, domiciliary, rest home, assisted living, or nursing facility. It is important to note that this code can only be used up to 9 times.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2008, healthcare providers should ensure that the following documentation requirements are met:

• Documentation should clearly indicate that the visit was a moderate in-home visit for an existing patient post-discharge.
• The duration of the visit should be documented as approximately 45 minutes.
• Details of the services provided during the visit should be clearly documented, including any assessments, interventions, or recommendations.
• Documentation should include the patient’s response to treatment and any changes in their condition.
• Providers should also include any relevant information regarding the patient’s post-discharge care plan or any referrals made for additional services.

6. Historical Information and Code Maintenance

HCPCS code G2008 was added to the Healthcare Common Procedure Coding System on January 01, 2019. 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

HCPCS code G2008 is subject to carrier judgment when it comes to coverage. The pricing indicator code 13 indicates that the price for this code is established by carriers, meaning it is not otherwise classified and is determined on an individual basis at the discretion of the carrier. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of scenarios in which HCPCS code G2008 should be billed:

1. An existing Medicare patient is discharged from a hospital and requires a 45-minute in-home visit for post-discharge care within 90 days.
2. A patient residing in an assisted living facility is discharged from a skilled nursing facility and requires a 45-minute in-home visit for post-discharge follow-up.
3. An existing patient is discharged from a rest home and requires a 45-minute in-home visit for ongoing monitoring and assessment.
4. A patient is discharged from a domiciliary and requires a 45-minute in-home visit for wound care and medication management.
5. An existing patient is discharged from a nursing facility and requires a 45-minute in-home visit for assistance with activities of daily living and rehabilitation exercises.