How To Use HCPCS Code G2146

HCPCS code G2146 describes the measurement and improvement of leg pain as measured by the visual analog scale (VAS) or numeric pain scale. This code is used to indicate that the level of leg pain at one year (9 to 15 months) postoperatively is less than or equal to 3.0 on the VAS or numeric pain scale. It can also be used when there is an improvement of 5.0 points or greater in leg pain measured within three months preoperatively and at one year postoperatively.

1. What is HCPCS G2146?

HCPCS code G2146 is a specific code used in medical coding to identify and document the level of leg pain experienced by a patient. It is important for medical coders to accurately assign this code to ensure proper reimbursement and tracking of leg pain management.

2. Official Description

The official description of HCPCS code G2146 is “Leg pain vas 9-15mo <= 3." This means that the level of leg pain, as measured by the visual analog scale or numeric pain scale, is less than or equal to 3.0 at one year (9 to 15 months) postoperatively.

3. Procedure

1. Before assigning HCPCS code G2146, the healthcare provider must measure the level of leg pain using the visual analog scale or numeric pain scale.
2. If the patient’s leg pain is less than or equal to 3.0 on the scale at one year postoperatively, HCPCS code G2146 should be assigned.
3. If the patient’s leg pain is not less than 3.0, or if the measurement is not available, HCPCS code G2146 should not be assigned.
4. It is important for the healthcare provider to accurately document the measurement of leg pain and the timeframe in which it was measured.

4. When to use HCPCS code G2146

HCPCS code G2146 should be used when the patient’s leg pain, as measured by the visual analog scale or numeric pain scale, meets the specific criteria outlined in the official description. This includes leg pain being less than or equal to 3.0 at one year postoperatively, or an improvement of 5.0 points or greater in leg pain measured within three months preoperatively and at one year postoperatively.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2146, healthcare providers must ensure that the documentation supports the criteria for using this code. This includes documenting the measurement of leg pain using the visual analog scale or numeric pain scale, as well as the timeframe in which it was measured. The documentation should also indicate whether the leg pain meets the specific criteria outlined in the official description.

6. Historical Information and Code Maintenance

HCPCS code G2146 was added to the Healthcare Common Procedure Coding System on January 01, 2020. As of January 01, 2023, 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

The coverage and reimbursement for HCPCS code G2146 may vary depending on the payer. It is important for healthcare providers to check with Medicare or other insurance providers to determine if this code is payable. The pricing indicator code for HCPCS code G2146 is 00, which means that the service is not separately priced by Part B. This indicates that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G2146 should be billed:

1. A patient undergoes a leg surgery and experiences a level of leg pain that is less than or equal to 3.0 on the visual analog scale at one year postoperatively.
2. A patient undergoes a leg surgery and experiences an improvement of 5.0 points or greater in leg pain measured within three months preoperatively and at one year postoperatively.
3. A patient undergoes a leg surgery and experiences a level of leg pain that is greater than 3.0 on the visual analog scale at one year postoperatively.
4. A patient undergoes a leg surgery, but the measurement of leg pain using the visual analog scale is not available.
5. A patient undergoes a leg surgery, but the measurement of leg pain using the visual analog scale is not documented within the specified timeframe.