How To Use HCPCS Code G9013

HCPCS code G9013 describes the Esrd demo basic bundle level i. This code is used to identify a specific bundle of services provided under the End-Stage Renal Disease (ESRD) demonstration program. In this article, we will explore the details of HCPCS code G9013, 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 G9013?

HCPCS code G9013 is a specific code used to identify the Esrd demo basic bundle level i. It is part of the Healthcare Common Procedure Coding System (HCPCS) and is used for medical coding and billing purposes. This code is non-covered by Medicare, which means it is not reimbursable by Medicare. The code was added to the HCPCS on July 01, 2004, and has an effective date of the same day.

2. Official Description

The official description of HCPCS code G9013 is “Esrd demo bundle level i.” The short description for this code is “Esrd demo basic bundle level i.” These descriptions provide a brief overview of the services included in this bundle.

3. Procedure

1. Step 1: The provider should determine if the patient meets the eligibility criteria for the ESRD demonstration program.
2. Step 2: If the patient is eligible, the provider should provide the necessary services included in the Esrd demo basic bundle level i.
3. Step 3: The services included in this bundle may vary, but they typically involve the management and treatment of end-stage renal disease.
4. Step 4: The provider should document the services provided and any relevant information for billing purposes.

4. When to use HCPCS code G9013

HCPCS code G9013 should be used when providing services that are included in the Esrd demo basic bundle level i. This code is specific to the ESRD demonstration program and should only be used for patients who meet the eligibility criteria for this program. It is important to review the program guidelines and requirements to ensure proper use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9013, healthcare providers should ensure that they have the necessary documentation to support the services provided. This may include medical records, treatment plans, and any other relevant documentation. It is important to follow the billing guidelines set forth by Medicare or other insurance providers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9013 was added to the Healthcare Common Procedure Coding System on July 01, 2004. 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. This code is used to identify a specific bundle of services under the ESRD demonstration program and has remained unchanged since its addition.

7. Medicare and Insurance Coverage

HCPCS code G9013 is non-covered by Medicare, which means it is not reimbursable by Medicare. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the services included in the Esrd demo basic bundle level i are bundled and not separately reimbursed. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9013 should be billed:

1. Example 1: A patient with end-stage renal disease receives the services included in the Esrd demo basic bundle level i.
2. Example 2: A healthcare provider participates in the ESRD demonstration program and provides the necessary services to eligible patients.
3. Example 3: A patient meets the eligibility criteria for the ESRD demonstration program and receives the services covered under the Esrd demo basic bundle level i.
4. Example 4: A healthcare facility provides the services included in the Esrd demo basic bundle level i to eligible patients.
5. Example 5: A healthcare provider documents and bills for the services included in the Esrd demo basic bundle level i for a patient with end-stage renal disease.