HCPCS code G4013 describes mental/behavioral and psychiatry MIPS specialty set. This code is used to identify services related to mental, behavioral, and psychiatric health. In this article, we will explore the details of HCPCS code G4013, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples.
1. What is HCPCS G4013?
HCPCS code G4013 is a specific code used to identify services related to mental/behavioral and psychiatry MIPS specialty set. It is important for medical coders to correctly assign this code to ensure accurate billing and reimbursement.
2. Official Description
The official description of HCPCS code G4013 is “Mental/behavioral and psychiatry MIPS specialty set.” The short description is “Mntal/behav/psych hlth ss.” These descriptions provide a general understanding of the services covered by this code.
3. Procedure
- Explain the procedure of HCPCS G4013 step by step with a lot of details.
4. When to use HCPCS code G4013
HCPCS code G4013 should be used in the context of mental, behavioral, and psychiatric health services. It is important to review the specific eligibility criteria or guidelines for using this code to ensure accurate coding and billing.
5. Billing Guidelines and Documentation Requirements
When using HCPCS code G4013, healthcare providers need to document the specific mental, behavioral, or psychiatric health services provided. They should also ensure that the documentation supports the medical necessity of the services. Proper billing for the service or supply is essential to ensure accurate reimbursement.
6. Historical Information and Code Maintenance
HCPCS code G4013 was added to the Healthcare Common Procedure Coding System on January 01, 2022. 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. It is important to stay updated on any changes or revisions to the code in the future.
7. Medicare and Insurance Coverage
Medicare and insurance coverage for HCPCS code G4013 may vary. It is important to review the pricing indicator code and multiple pricing indicator code to understand how the service or supply is priced by Medicare or other insurers. The pricing indicator code 00 indicates that the service is not separately priced by Part B, while the multiple pricing indicator code 9 indicates that the value is not established or the code is not priced separately by Part B.
8. Examples
Here are five detailed examples of when HCPCS code G4013 should be billed:
- Example 1: A patient with a diagnosed mental health disorder receives individual therapy sessions.
- Example 2: A psychiatrist provides medication management services for a patient with a psychiatric condition.
- Example 3: A behavioral health specialist conducts a group therapy session for individuals with substance abuse issues.
- Example 4: A psychologist performs psychological testing for a patient with a suspected cognitive impairment.
- Example 5: A mental health counselor provides counseling services to a patient with anxiety and depression.
