How To Use HCPCS Code G8981

HCPCS code G8981 describes the changing and maintaining of body position functional limitation at therapy episode outset and at reporting intervals. This code is used to identify the current status of a patient’s body position and the need for therapy to address any limitations in this area. In this article, we will explore the details of HCPCS code G8981, 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 G8981?

HCPCS code G8981 is a specific code used in medical coding to identify the changing and maintaining of body position functional limitation at therapy episode outset and at reporting intervals. It is important to note that this code is specific to the current status of a patient’s body position and is used in the context of therapy services.

2. Official Description

The official description of HCPCS code G8981 is “Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals.” The short description for this code is “Body pos current status.”

3. Procedure

1. The provider assesses the patient’s body position functional limitation at the therapy episode outset.
2. The provider determines the appropriate therapy interventions to address any limitations in body position.
3. Throughout the therapy episode, the provider regularly evaluates and documents the patient’s current status of body position functional limitation.
4. If necessary, the provider adjusts the therapy interventions to ensure the patient’s body position is changing and being maintained appropriately.
5. At reporting intervals, the provider updates the patient’s current status of body position functional limitation and documents any changes or progress made.

4. When to use HCPCS code G8981

HCPCS code G8981 should be used when documenting and billing for therapy services related to the changing and maintaining of body position functional limitation. This code is specifically used to indicate the current status of the patient’s body position and the need for therapy interventions to address any limitations in this area. It is important to ensure that the patient meets the eligibility criteria for therapy services and that the documentation supports the medical necessity of the interventions.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8981, healthcare providers need to document the patient’s current status of body position functional limitation, the therapy interventions provided, and any changes or progress made throughout the therapy episode. It is important to include detailed information on the therapy interventions, such as the techniques used, duration of therapy sessions, and any equipment or aids utilized. The documentation should support the medical necessity of the therapy services and demonstrate the patient’s response to the interventions.

6. Historical Information and Code Maintenance

HCPCS code G8981 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It has an effective date of January 01, 2020, indicating that any services or supplies billed with this code should reflect the updated guidelines and requirements. As of December 31, 2019, this code has been terminated, and no maintenance actions are applicable. It is important for medical coders and healthcare providers to ensure they are using the most up-to-date codes and guidelines for accurate billing and documentation.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G8981 may vary. It is essential to consult the specific coverage policies of the payer to determine if this code is payable. The pricing indicator code for this code is 00, indicating that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers. The multiple pricing indicator code is 9, indicating that the value for this code is not established. It is important to verify the coverage and reimbursement policies with the payer to ensure accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code G8981 should be billed:

1. A patient with a functional limitation in body position due to a musculoskeletal condition receives physical therapy to improve their ability to change and maintain body positions.
2. A patient with a neurological impairment requires occupational therapy to address their body position functional limitation and improve their independence in daily activities.
3. A patient recovering from a stroke undergoes speech therapy to address their body position functional limitation during communication and swallowing exercises.
4. A patient with a chronic pain condition receives therapeutic interventions, including body positioning techniques, to manage their symptoms and improve their functional abilities.
5. A patient with a mobility impairment receives therapy services to address their body position functional limitation and improve their ability to transfer and ambulate.