How To Use HCPCS Code G8949

HCPCS code G8949 describes the documentation of patient reasons for not receiving counseling for diet and physical activity. This code is used when a patient is unwilling to discuss interventions related to diet or exercise to help control their blood pressure, or if the patient explicitly refuses to make these changes.

1. What is HCPCS G8949?

HCPCS code G8949 is a specific code used in medical coding to identify the documentation of patient reasons for not receiving counseling for diet and physical activity. It is important for healthcare providers to accurately document the patient’s reasons for not receiving counseling in order to provide a comprehensive medical record.

2. Official Description

The official description of HCPCS code G8949 is “Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes).” The short description for this code is “Doc pt reas on counsel diet.”

3. Procedure

1. The healthcare provider should have a conversation with the patient about counseling for diet and physical activity.
2. If the patient is unwilling to discuss diet or exercise interventions to help control their blood pressure, or if the patient refuses to make these changes, the provider should document the patient’s reasons in the medical record.
3. The documentation should include specific details about the patient’s reasons for not receiving counseling, such as their refusal to make dietary changes or engage in physical activity.
4. The provider should ensure that the documentation is clear, concise, and accurately reflects the patient’s reasons for not receiving counseling.

4. When to use HCPCS code G8949

HCPCS code G8949 should be used when a patient is unwilling to discuss interventions related to diet or exercise to help control their blood pressure, or if the patient explicitly refuses to make these changes. It is important for healthcare providers to accurately document the patient’s reasons for not receiving counseling in order to provide a comprehensive medical record.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8949, healthcare providers need to ensure that they have documented the patient’s reasons for not receiving counseling for diet and physical activity. This documentation should be clear, concise, and accurately reflect the patient’s refusal or unwillingness to engage in interventions related to diet and exercise. The documentation should be included in the patient’s medical record and can be used to support the medical necessity of the services provided.

6. Historical Information and Code Maintenance

HCPCS code G8949 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has a termination date of December 31, 2014. 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

HCPCS code G8949 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means that the value for this code is not established. This could be due to the code not being priced separately by Part B or the value not being established.

8. Examples

Here are five examples of when HCPCS code G8949 should be billed:

1. A patient with high blood pressure refuses to discuss dietary changes or exercise interventions to help control their blood pressure.
2. A patient is unwilling to engage in counseling for diet and physical activity despite having a medical condition that would benefit from these interventions.
3. A patient explicitly refuses to make any changes to their diet or engage in physical activity, even though it is recommended for their health.
4. A patient with a history of heart disease refuses to discuss dietary changes or exercise interventions to help manage their condition.
5. A patient with diabetes refuses to engage in counseling for diet and physical activity, despite the potential benefits for blood sugar control.