How To Use HCPCS Code G8990

HCPCS code G8990 describes a specific type of physical or occupational therapy primary functional limitation. This code is used to indicate the current status of the patient’s condition at the outset of therapy and at reporting intervals. 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 G8990?

HCPCS code G8990 is used to identify other physical or occupational therapy primary functional limitations. This code specifically refers to the current status of the patient’s condition at the beginning of therapy and at subsequent reporting intervals. It is important to note that this code was terminated on December 31, 2019, and is no longer in use.

2. Official Description

The official description of HCPCS code G8990 is “Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals.” The short description for this code is “Other pt/ot current status.”

3. Procedure

1. During the therapy episode outset, the healthcare provider assesses the patient’s current functional limitations.
2. The provider documents the specific primary functional limitation that is being addressed through physical or occupational therapy.
3. At subsequent reporting intervals, the provider reassesses the patient’s current status and documents any changes or improvements in the functional limitation.
4. The provider may use various assessment tools and techniques to evaluate the patient’s progress and adjust the therapy plan accordingly.

4. When to use HCPCS code G8990

HCPCS code G8990 should be used when documenting and reporting the current status of a patient’s physical or occupational therapy primary functional limitation. This code is specifically used at the outset of therapy and at reporting intervals to track the progress and effectiveness of the therapy provided.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G8990, healthcare providers need to ensure proper documentation of the patient’s functional limitation, the therapy provided, and the progress made at each reporting interval. It is important to include detailed notes and any relevant assessment results to support the medical necessity of the therapy and the use of this specific code.

6. Historical Information and Code Maintenance

HCPCS code G8990 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It had an effective date of January 01, 2020, indicating that it was terminated at the end of 2019. The termination of this code means that it is no longer valid for billing or reporting purposes.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may have specific coverage policies for physical or occupational therapy services. It is important to check with the respective payer to determine if HCPCS code G8990 is payable and to understand any specific requirements or guidelines for reimbursement.

8. Examples

Here are five examples of when HCPCS code G8990 may have been used:

1. A patient with a primary functional limitation in range of motion undergoes physical therapy to improve flexibility and mobility.
2. A patient with a primary functional limitation in fine motor skills receives occupational therapy to enhance dexterity and coordination.
3. A patient with a primary functional limitation in balance and coordination undergoes physical therapy to improve stability and prevent falls.
4. A patient with a primary functional limitation in activities of daily living receives occupational therapy to regain independence in self-care tasks.
5. A patient with a primary functional limitation in strength and endurance undergoes physical therapy to increase muscle power and stamina.