How To Use HCPCS Code G2122

HCPCS code G2122 describes the assessment and evaluation of patients with symptoms of depression, anxiety, apathy, and psychosis. This code is used to identify the specific services provided by healthcare professionals to assess and diagnose these mental health conditions. In this article, we will explore the details of HCPCS code G2122, 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 G2122?

HCPCS code G2122 is used to identify the assessment and evaluation of patients presenting with symptoms of depression, anxiety, apathy, and psychosis. It allows healthcare providers to document and bill for the services provided in diagnosing and managing these mental health conditions. This code is essential for accurate medical coding and billing, ensuring proper reimbursement for the services rendered.

2. Official Description

The official description of HCPCS code G2122 is “Depression, anxiety, apathy, and psychosis not assessed.” The short description is “Psy/dep/anx/apandicd noasse.” This description indicates that the code is used when the healthcare provider does not assess or evaluate the mentioned mental health conditions in the patient.

3. Procedure

1. The healthcare provider should conduct a comprehensive evaluation of the patient’s medical history, including any previous diagnoses or treatments related to depression, anxiety, apathy, or psychosis.
2. During the assessment, the provider should gather information about the patient’s symptoms, duration, severity, and any associated factors.
3. They should perform a thorough physical examination to rule out any underlying medical conditions that may contribute to the patient’s mental health symptoms.
4. The provider may use standardized assessment tools or questionnaires to gather additional information and assess the patient’s mental health status.
5. Based on the evaluation, the provider should document their findings and determine the appropriate course of treatment or referral for further evaluation if necessary.

4. When to use HCPCS code G2122

HCPCS code G2122 should be used when the healthcare provider does not assess or evaluate the patient for depression, anxiety, apathy, or psychosis. It is important to use this code accurately to reflect the services provided and ensure proper reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2122, healthcare providers should ensure the following documentation requirements are met:

• Clearly document the reason for not assessing or evaluating the mentioned mental health conditions.
• Include relevant information from the patient’s medical history, physical examination, and any standardized assessment tools used.
• Ensure the documentation supports the medical necessity of not assessing or evaluating the patient for depression, anxiety, apathy, or psychosis.

6. Historical Information and Code Maintenance

HCPCS code G2122 was added to the Healthcare Common Procedure Coding System on January 01, 2020. As of the effective date of January 01, 2022, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The pricing indicator code 00 indicates that the service is not separately priced by Part B and may be bundled or not covered.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G2122 may vary depending on the carrier’s judgment. It is important to check with Medicare or other insurance providers to determine their specific coverage policies for this code. The pricing indicator code 00 suggests that the service is not separately priced by Part B and may not be covered or bundled with other services.

8. Examples

Here are five examples of scenarios where HCPCS code G2122 should be billed:

1. A patient presents with symptoms of depression, anxiety, apathy, and psychosis, but the healthcare provider determines that further assessment is not necessary due to a recent comprehensive evaluation.
2. A patient with a known history of depression and anxiety visits their primary care physician for an unrelated issue. The provider decides not to assess or evaluate the mental health conditions during this visit.
3. A patient is referred to a specialist for evaluation of depression, anxiety, apathy, and psychosis. However, after reviewing the patient’s medical records, the specialist determines that the assessment has already been adequately performed, and no further evaluation is required.
4. A patient presents with symptoms suggestive of depression, anxiety, apathy, and psychosis, but the healthcare provider determines that the symptoms are primarily related to a medical condition and not a primary mental health disorder.
5. A patient with a known history of depression and anxiety visits a psychiatrist for medication management. The psychiatrist decides not to assess or evaluate the mental health conditions during this visit, as the patient’s symptoms are stable and well-managed.