How To Use HCPCS Code G9008

HCPCS code G9008 describes the coordinated care fee for physician coordinated care oversight services. This code is used to identify and bill for the services provided by physicians who oversee and coordinate the care of patients. In this article, we will explore the details of HCPCS code G9008, 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 G9008?

HCPCS code G9008 is used to identify the coordinated care fee for physician coordinated care oversight services. It is specifically designed for physicians who are responsible for overseeing and coordinating the care of patients. This code is used to bill for the time and effort spent by physicians in managing and coordinating the care of their patients.

2. Official Description

The official description of HCPCS code G9008 is “Coordinated care fee, physician coordinated care oversight services”. The short description for this code is “Mccd,phys coor-care ovrsght”.

3. Procedure

1. Physicians who provide coordinated care oversight services should document the time spent on coordinating and managing the care of their patients.
2. This code should be used to bill for the time spent on activities such as reviewing medical records, communicating with other healthcare providers, coordinating referrals, and developing care plans.
3. It is important for physicians to accurately document the time spent on each patient and the specific activities performed.
4. When submitting the claim, the physician should include the appropriate units of service to reflect the total time spent on coordinated care oversight services.

4. When to use HCPCS code G9008

HCPCS code G9008 should be used when physicians provide coordinated care oversight services to their patients. This code is applicable when physicians spend time managing and coordinating the care of their patients, including activities such as reviewing medical records, communicating with other healthcare providers, coordinating referrals, and developing care plans.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9008, healthcare providers should ensure that the following documentation requirements are met:

• Accurate documentation of the time spent on coordinated care oversight services for each patient.
• Documentation of the specific activities performed during the coordinated care oversight.
• Inclusion of the appropriate units of service to reflect the total time spent on coordinated care oversight services.

6. Historical Information and Code Maintenance

HCPCS code G9008 was added to the Healthcare Common Procedure Coding System on October 01, 2000. Since its addition, there have been no maintenance actions 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 G9008 is covered by Medicare and other insurance providers. However, it is important to note that the pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service may be bundled or not covered by Medicare or other insurers. It is recommended to check with the specific payer for coverage and reimbursement details.

8. Examples

Here are five examples of when HCPCS code G9008 should be billed:

1. A primary care physician spends 30 minutes reviewing medical records, communicating with specialists, and developing a care plan for a patient with multiple chronic conditions.
2. An oncologist spends 45 minutes coordinating the care of a cancer patient, including reviewing test results, discussing treatment options with the patient, and coordinating referrals to other specialists.
3. A psychiatrist spends 20 minutes reviewing a patient’s psychiatric history, consulting with the patient’s therapist, and adjusting the patient’s medication regimen.
4. A pediatrician spends 15 minutes coordinating the care of a child with developmental delays, including communicating with early intervention providers and reviewing therapy progress.
5. An internal medicine physician spends 25 minutes managing the care of a patient with complex medical conditions, including coordinating referrals to specialists and reviewing treatment plans.