How To Use HCPCS Code G8735

HCPCS code G8735 describes an elder maltreatment screen that has been documented as positive, but with no follow-up plan documented and no reason given. This code is used to indicate that an assessment for elder maltreatment has been conducted and the results were positive, but there is no documented plan for further action or intervention. It is important for medical coders to understand the specific meaning and usage of this code in order to accurately report and bill for this service.

1. What is HCPCS G8735?

HCPCS code G8735 is used to identify an elder maltreatment screen that has been documented as positive, but with no follow-up plan documented and no reason given. This code specifically pertains to cases where an assessment for elder maltreatment has been conducted and the results indicate a positive finding. However, it is important to note that there is no documented plan for further action or intervention, and no reason is provided for the lack of follow-up.

2. Official Description

The official description of HCPCS code G8735 is “Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given.” The short description for this code is “Eld mal scrn pos no plan.”

3. Procedure

1. The healthcare provider initiates an elder maltreatment screen for a patient who is suspected of being a victim of maltreatment.
2. The screen involves a comprehensive assessment of the patient’s physical, emotional, and psychological well-being, as well as an evaluation of any signs or symptoms of abuse or neglect.
3. If the assessment reveals positive findings indicating elder maltreatment, the provider documents the results accordingly.
4. However, in cases where HCPCS code G8735 is applicable, the provider fails to document a follow-up plan for the patient and does not provide a reason for the lack of follow-up.

4. When to use HCPCS code G8735

HCPCS code G8735 should be used when an elder maltreatment screen has been conducted and the results indicate a positive finding. However, it is important to note that this code is specifically used when there is no documented follow-up plan and no reason is provided for the lack of follow-up. It is crucial for medical coders to accurately apply this code in cases where all the specified criteria are met.

5. Billing Guidelines and Documentation Requirements

When reporting HCPCS code G8735, healthcare providers need to ensure that the following documentation requirements are met:

• The documentation should clearly indicate that an elder maltreatment screen was conducted.
• The results of the screen should be documented as positive.
• There should be no documented follow-up plan for the patient.
• No reason should be provided for the lack of follow-up.

It is important for providers to accurately document and bill for this service in order to ensure proper reimbursement and compliance with coding guidelines.

6. Historical Information and Code Maintenance

HCPCS code G8735 was added to the Healthcare Common Procedure Coding System on January 1, 2012. It has an action effective date of January 1, 2013. As indicated by the action code N, there is no maintenance for this code, meaning that no updates or revisions have been made since its addition.

7. Medicare and Insurance Coverage

HCPCS code G8735 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the service is either not covered, bundled with other services, or only used by Part A. The multiple pricing indicator code is 9, which means that the value for this code is not established or applicable as HCPCS G8735 is not priced separately by Part B.

8. Examples

Here are five examples of scenarios where HCPCS code G8735 should be billed:

1. An elderly patient undergoes an assessment for elder maltreatment, and the results indicate a positive finding. However, no follow-up plan is documented, and no reason is given for the lack of follow-up.
2. A healthcare provider conducts an elder maltreatment screen for a patient who is suspected of being a victim of abuse or neglect. The screen reveals positive findings, but no follow-up plan is documented, and no reason is provided for the lack of follow-up.
3. During a routine check-up, an elderly patient is assessed for elder maltreatment. The results of the screen indicate a positive finding, but the provider fails to document a follow-up plan and does not provide a reason for the lack of follow-up.
4. An elderly patient is referred to a specialist for an elder maltreatment screen. The assessment reveals positive findings, but no follow-up plan is documented, and no reason is given for the lack of follow-up.
5. A healthcare provider conducts an elder maltreatment screen for an elderly patient who has been exhibiting signs of abuse. The screen confirms the presence of maltreatment, but the provider does not document a follow-up plan and does not provide a reason for the lack of follow-up.