How To Use HCPCS Code G2079

HCPCS code G2079 describes the provision of a take-home supply of buprenorphine (oral) for up to 7 additional days by a Medicare-enrolled opioid treatment program. This code is used to identify and bill for the specific service of providing a take-home supply of buprenorphine to patients who are undergoing treatment for opioid addiction.

1. What is HCPCS G2079?

HCPCS code G2079 is a specific code used in medical coding to identify and bill for the provision of a take-home supply of buprenorphine (oral) by a Medicare-enrolled opioid treatment program. This code is used to indicate that the patient is receiving a supply of buprenorphine to take home and continue their treatment for opioid addiction.

2. Official Description

The official description of HCPCS code G2079 is “Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a Medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure.” The short description of this code is “Take-home buprenorphine.”

3. Procedure

1. The provider assesses the patient’s eligibility for take-home buprenorphine based on their progress in the opioid treatment program and adherence to program requirements.
2. If the patient meets the criteria for take-home buprenorphine, the provider prescribes the appropriate dosage and duration of the take-home supply.
3. The provider educates the patient on the proper use and storage of buprenorphine and provides any necessary instructions or counseling.
4. The provider documents the provision of the take-home supply of buprenorphine in the patient’s medical record.
5. The provider bills for the service using HCPCS code G2079, indicating the provision of a take-home supply of buprenorphine by a Medicare-enrolled opioid treatment program.

4. When to use HCPCS code G2079

HCPCS code G2079 should be used when a Medicare-enrolled opioid treatment program provides a take-home supply of buprenorphine (oral) to a patient for up to 7 additional days. This code is used to indicate that the patient is receiving a take-home supply of buprenorphine as part of their treatment for opioid addiction.

5. Billing Guidelines and Documentation Requirements

When billing for the provision of a take-home supply of buprenorphine using HCPCS code G2079, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s eligibility for take-home buprenorphine based on program requirements.
• Prescription details, including dosage and duration of the take-home supply.
• Evidence of patient education and counseling on the use and storage of buprenorphine.
• Documentation of the provision of the take-home supply in the patient’s medical record.

6. Historical Information and Code Maintenance

HCPCS code G2079 was added to the Healthcare Common Procedure Coding System on January 01, 2020. 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 G2079 is payable by Medicare. The pricing indicator code 13 indicates that the price for this service is established by carriers, based on carrier discretion. 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 when HCPCS code G2079 should be billed:

1. A patient who has successfully completed the initial phase of an opioid treatment program and is eligible for take-home buprenorphine.
2. A patient who is unable to attend daily treatment sessions due to transportation or other logistical challenges and requires a take-home supply of buprenorphine.
3. A patient who is transitioning from inpatient to outpatient treatment and requires a take-home supply of buprenorphine to continue their treatment.
4. A patient who is traveling and needs a take-home supply of buprenorphine to ensure continuity of their treatment while away from the treatment facility.
5. A patient who has demonstrated consistent adherence to the treatment program and has met the criteria for take-home buprenorphine as outlined by the program.