How To Use HCPCS Code G9159

HCPCS code G9159 describes the functional limitation of spoken language comprehension and is used to indicate the current status of this limitation at the therapy episode outset and at reporting intervals. This code was terminated on December 31, 2019, and has specific coverage and action codes associated with it.

1. What is HCPCS G9159?

HCPCS code G9159 is used to identify the functional limitation of spoken language comprehension. It specifically indicates the current status of this limitation at the therapy episode outset and at reporting intervals. This code helps healthcare providers track and document the progress of patients with spoken language comprehension difficulties.

2. Official Description

The official description of HCPCS code G9159 is “Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals.” The short description for this code is “Lang comp current status.”

3. Procedure

1. During the therapy episode outset, the healthcare provider assesses the patient’s spoken language comprehension abilities.
2. The provider evaluates the patient’s comprehension skills by administering various tests and exercises.
3. Based on the assessment results, the provider determines the patient’s current status of spoken language comprehension functional limitation.
4. Throughout the therapy episode, the provider periodically reassesses the patient’s spoken language comprehension abilities to track progress and make any necessary adjustments to the treatment plan.
5. The provider documents the current status of spoken language comprehension functional limitation at reporting intervals.

4. When to use HCPCS code G9159

HCPCS code G9159 should be used when documenting the current status of spoken language comprehension functional limitation at the therapy episode outset and at reporting intervals. This code is applicable for patients who have difficulties understanding spoken language and helps healthcare providers monitor their progress over time.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9159, healthcare providers need to document the patient’s spoken language comprehension abilities at the therapy episode outset and at reporting intervals. This documentation should include the results of assessments, tests, and exercises used to evaluate the patient’s comprehension skills. It is important to accurately record the current status of spoken language comprehension functional limitation to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9159 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It has an effective date of January 01, 2020, indicating that any services or supplies associated with this code should be billed accordingly starting from that date. The code has a pricing indicator code of 00, which means it is not separately priced by Part B. 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

Medicare and other insurance providers may cover services or supplies associated with HCPCS code G9159. However, the specific coverage may vary depending on the carrier’s judgment. It is important to check with the respective insurance provider to determine the coverage and reimbursement policies for this code. The multiple pricing indicator code for G9159 is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9159 should be billed:

1. A patient with a history of language comprehension difficulties undergoes a therapy session where their current status of spoken language comprehension functional limitation is assessed and documented.
2. A speech therapist evaluates a child’s spoken language comprehension abilities at the therapy episode outset and periodically reassesses their progress throughout the treatment.
3. An adult with a brain injury receives speech therapy to improve their spoken language comprehension skills. The therapist documents the patient’s current status of functional limitation at reporting intervals.
4. A patient with a language disorder undergoes therapy sessions to enhance their spoken language comprehension. The provider tracks the patient’s progress by documenting their current status at reporting intervals.
5. A healthcare provider assesses the spoken language comprehension abilities of an elderly patient with cognitive impairments. The provider uses HCPCS code G9159 to indicate the patient’s current status of functional limitation at the therapy episode outset.