How To Use HCPCS Code G8987

HCPCS code G8987 describes a self-care functional limitation, current status, at therapy episode outset and at reporting intervals. This code is used to indicate the patient’s ability to perform self-care activities and the level of assistance required. It is important for medical coders to understand the meaning and usage of this code in order to accurately document and bill for the services provided.

1. What is HCPCS G8987?

HCPCS code G8987 is used to identify the current status of a patient’s self-care functional limitation at the beginning of a therapy episode and at reporting intervals. It provides information on the patient’s ability to perform self-care activities such as bathing, dressing, grooming, and feeding. This code helps healthcare providers assess the patient’s level of independence and determine the appropriate treatment plan.

2. Official Description

The official description of HCPCS code G8987 is “Self care functional limitation, current status, at therapy episode outset and at reporting intervals.” The short description for this code is “Self care current status.”

3. Procedure

1. During the therapy episode outset, the healthcare provider assesses the patient’s self-care functional limitation.
2. The provider evaluates the patient’s ability to perform self-care activities such as bathing, dressing, grooming, and feeding.
3. The provider documents the patient’s current status of self-care functional limitation using HCPCS code G8987.
4. At reporting intervals, the provider reassesses the patient’s self-care functional limitation and updates the documentation if necessary.

4. When to use HCPCS code G8987

HCPCS code G8987 should be used when documenting the patient’s current status of self-care functional limitation at the therapy episode outset and at reporting intervals. It is important to use this code accurately to provide a comprehensive picture of the patient’s abilities and limitations in performing self-care activities.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G8987, healthcare providers need to document the patient’s current status of self-care functional limitation. This documentation should include a detailed assessment of the patient’s ability to perform self-care activities and any assistance required. It is important to provide clear and concise documentation to support the medical necessity of the services provided.

6. Historical Information and Code Maintenance

HCPCS code G8987 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has a coverage code of C, which indicates that carrier judgment is used to determine coverage. The code has an action code of N, meaning no maintenance is required. The code was terminated on December 31, 2019, and is no longer valid for billing purposes.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover services associated with HCPCS code G8987. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the code is not applicable for separate pricing by Part B or the value is not established. It is important to check with individual payers for specific coverage and reimbursement guidelines.

8. Examples

Here are five examples of when HCPCS code G8987 should be billed:

1. A patient with a recent stroke who requires assistance with bathing and dressing.
2. An elderly patient with limited mobility who needs help with grooming and feeding.
3. A patient recovering from surgery who is unable to perform self-care activities independently.
4. A child with a physical disability who requires assistance with all self-care activities.
5. A patient with a chronic illness that affects their ability to perform self-care tasks.