How To Use HCPCS Code G8995

HCPCS code G8995 describes a specific type of physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting. This code is used to indicate the patient’s functional limitation at the time of discharge from therapy or to signify the end of reporting for therapy services.

1. What is HCPCS G8995?

HCPCS code G8995 is a specific code used in medical coding to identify the discharge status or end of reporting for physical or occupational therapy services. It is important to use this code accurately to ensure proper documentation and billing for therapy services.

2. Official Description

The official description of HCPCS code G8995 is “Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting.” The short description for this code is “Sub pt/ot d/c status.”

3. Procedure

1. When using HCPCS code G8995, the healthcare provider should assess the patient’s functional limitation at the time of discharge from therapy or when reporting for therapy services is ending.
2. The provider should document the specific functional limitation or status of the patient at the time of discharge or end of reporting.
3. This code should be used to indicate the patient’s functional limitation or discharge status accurately.

4. When to use HCPCS code G8995

HCPCS code G8995 should be used in the following contexts:

• When a patient is being discharged from physical or occupational therapy
• When reporting for therapy services is ending
• To indicate the patient’s functional limitation at the time of discharge or end of reporting

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G8995, healthcare providers should:

• Ensure accurate documentation of the patient’s functional limitation or discharge status at the time of discharge or end of reporting
• Include the appropriate supporting documentation to justify the use of this code
• Follow the billing guidelines set forth by Medicare or other insurance providers

6. Historical Information and Code Maintenance

HCPCS code G8995 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It has a termination date of December 31, 2019. No maintenance actions have been 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 G8995 may be covered by Medicare or other insurance providers. 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, which indicates that the value is not established or applicable as HCPCS G8995 is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G8995 should be billed:

1. A patient is discharged from physical therapy after completing a course of treatment for a knee injury. The functional limitation at discharge is documented using HCPCS code G8995.
2. An individual completes a series of occupational therapy sessions to improve fine motor skills. The therapy services end, and the patient’s functional limitation at the end of reporting is indicated with HCPCS code G8995.
3. A patient with a back injury completes a course of physical therapy. The discharge status, indicating the functional limitation at the time of discharge, is documented using HCPCS code G8995.
4. An individual receives physical therapy for a shoulder injury. The therapy services end, and the patient’s functional limitation at the end of reporting is accurately recorded with HCPCS code G8995.
5. A patient completes a series of occupational therapy sessions to improve activities of daily living. The therapy services end, and the functional limitation at the end of reporting is documented using HCPCS code G8995.