How To Use HCPCS Code G8978

HCPCS code G8978 describes the current status of mobility, specifically walking and moving around functional limitation, at the outset of a therapy episode and at reporting intervals. This code is used to indicate the level of mobility impairment a patient has and is important for tracking progress and determining appropriate treatment plans.

1. What is HCPCS G8978?

HCPCS code G8978 is a specific code used in medical coding to identify the current status of mobility limitations in patients. It is used to indicate the level of impairment a patient has in walking and moving around at the beginning of a therapy episode and at regular reporting intervals. This code provides valuable information for healthcare providers to assess the functional limitations of a patient’s mobility and to develop appropriate treatment plans.

2. Official Description

The official description of HCPCS code G8978 is “Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals.” This description accurately reflects the purpose of the code, which is to capture the current level of mobility impairment in patients.

3. Procedure

1. The healthcare provider assesses the patient’s mobility limitations at the beginning of a therapy episode or at regular reporting intervals.
2. The provider evaluates the patient’s ability to walk and move around, taking into account any functional limitations.
3. The provider documents the patient’s current status of mobility impairment.
4. The provider assigns HCPCS code G8978 to indicate the level of mobility impairment.

4. When to use HCPCS code G8978

HCPCS code G8978 should be used when documenting the current status of mobility limitations in patients at the outset of a therapy episode and at reporting intervals. This code is specifically for capturing the functional limitations in walking and moving around. It is important to use this code accurately to provide an accurate representation of the patient’s mobility impairment.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8978, healthcare providers need to ensure proper documentation of the patient’s current status of mobility impairment. This includes detailed information about the functional limitations in walking and moving around. The documentation should support the medical necessity of assessing and monitoring the patient’s mobility limitations. Proper documentation is crucial for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G8978 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has an effective date of January 1, 2020, indicating that it is still an active code. As of December 31, 2019, 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 for medical coders to stay updated on any changes or revisions to HCPCS codes to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the assessment and monitoring of mobility limitations using HCPCS code G8978. However, it is essential to verify coverage with the specific insurance plan. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service may be bundled or not covered separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS G8978 is not priced separately by Part B or the value is not established. It is important to review the specific guidelines and policies of Medicare or other insurance providers for accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code G8978 should be billed:

1. A patient with a recent hip replacement surgery who is experiencing difficulty walking and moving around due to post-operative pain and limited range of motion.
2. A patient with a neurological condition that affects their ability to walk and move around independently.
3. A patient with a musculoskeletal injury that hinders their mobility and requires physical therapy for rehabilitation.
4. A patient with a chronic illness that causes fatigue and weakness, resulting in mobility limitations.
5. A patient recovering from a stroke who has partial paralysis and requires assistance with walking and moving around.