How To Use HCPCS Code G8431

HCPCS code G8431 describes the documentation and follow-up process for screening for depression. This code is used to indicate that a screening for depression has been performed and that a follow-up plan has been documented. In this article, we will explore the details of HCPCS code G8431, 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 G8431?

HCPCS code G8431 is used to identify the documentation and follow-up process for screening for depression. It indicates that a screening for depression has been performed and that a follow-up plan has been documented. This code is specific to the healthcare industry and is used by medical coders to accurately represent the services provided.

2. Official Description

The official description of HCPCS code G8431 is “Screening for depression is documented as being positive and a follow-up plan is documented.” The short description is “Pos clin depres scrn f/u doc.” These descriptions provide a concise summary of the purpose and usage of this code.

3. Procedure

1. The healthcare provider begins by conducting a screening for depression.
2. If the screening results indicate a positive finding for depression, the provider proceeds to document this positive result.
3. Following the documentation of a positive screening result, the provider then documents a follow-up plan.
4. The follow-up plan may include recommendations for further evaluation, treatment options, or referrals to mental health professionals.
5. All relevant information regarding the screening, positive result, and follow-up plan should be accurately documented in the patient’s medical record.

4. When to use HCPCS code G8431

HCPCS code G8431 should be used when a healthcare provider has conducted a screening for depression and has documented a positive result, as well as a follow-up plan. It is important to ensure that all necessary documentation is in place to support the use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8431, healthcare providers should ensure that the following documentation requirements are met:

• The screening for depression must be documented as positive.
• A follow-up plan must be documented.
• All relevant information should be accurately recorded in the patient’s medical record.

Providers should also follow the billing guidelines set forth by the relevant insurance carriers or Medicare to ensure proper reimbursement for the services rendered.

6. Historical Information and Code Maintenance

HCPCS code G8431 was added to the Healthcare Common Procedure Coding System on January 01, 2008. As of January 01, 2017, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code is classified as a medical care service and is not separately priced by Part B.

7. Medicare and Insurance Coverage

HCPCS code G8431 is covered by Medicare and other insurance providers. However, it is important to note that the pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the value for this code is not established. Providers should consult the Medicare or insurance guidelines for specific reimbursement details.

8. Examples

Here are five examples of when HCPCS code G8431 should be billed:

1. A patient visits their primary care physician for a routine check-up. During the visit, the physician conducts a screening for depression, which yields a positive result. The physician then documents a follow-up plan, including a referral to a mental health specialist. HCPCS code G8431 should be billed to indicate the screening and follow-up documentation.
2. A psychiatrist sees a new patient who presents with symptoms of depression. The psychiatrist conducts a comprehensive evaluation, including a screening for depression. The screening results indicate a positive finding, and the psychiatrist documents a follow-up plan, which includes medication management and therapy sessions. HCPCS code G8431 should be billed to indicate the screening and follow-up documentation.
3. A patient visits an outpatient mental health clinic for an initial assessment. As part of the assessment, the clinician conducts a screening for depression, which reveals a positive result. The clinician documents a follow-up plan, which includes weekly therapy sessions and a referral for a psychiatric evaluation. HCPCS code G8431 should be billed to indicate the screening and follow-up documentation.
4. A nurse practitioner conducts a telehealth visit with a patient who has been experiencing symptoms of depression. During the visit, the nurse practitioner performs a screening for depression, which shows a positive result. The nurse practitioner documents a follow-up plan, which includes regular check-ins and a referral to a local mental health resource. HCPCS code G8431 should be billed to indicate the screening and follow-up documentation.
5. A patient presents to an emergency department with acute distress and suicidal ideation. The emergency department physician conducts a screening for depression, which reveals a positive result. The physician documents a follow-up plan, which includes immediate psychiatric evaluation and hospitalization. HCPCS code G8431 should be billed to indicate the screening and follow-up documentation.