How To Use HCPCS Code G9162

HCPCS code G9162 describes the functional limitation of spoken language expression and is used to indicate the current status of this limitation at the beginning of a therapy episode and at reporting intervals. This code was terminated on December 31, 2019, and is no longer in use. Let’s explore the details of HCPCS code G9162 and its various aspects.

1. What is HCPCS G9162?

HCPCS code G9162 is a specific code used in medical coding to identify the functional limitation of spoken language expression. It provides information about 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 speech and language impairments.

2. Official Description

The official description of HCPCS code G9162 is “Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals.” The short description for this code is “Lang express current status.”

3. Procedure

1. During the therapy episode outset, the healthcare provider assesses the patient’s spoken language expression abilities.
2. The provider evaluates the patient’s current status in terms of functional limitation in spoken language expression.
3. At reporting intervals, the provider reassesses the patient’s spoken language expression abilities to track any changes or improvements.
4. The provider documents the findings and updates the patient’s medical records accordingly.

4. When to use HCPCS code G9162

HCPCS code G9162 should be used when documenting the functional limitation of spoken language expression at the therapy episode outset and at reporting intervals. It is typically used in the context of speech therapy or language intervention services. This code helps healthcare providers monitor the progress of patients with speech and language impairments over time.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9162, healthcare providers need to ensure accurate and detailed documentation. The medical records should include information about the patient’s spoken language expression abilities, the functional limitation present, and any changes observed during the therapy episode or reporting intervals. This documentation is crucial for proper reimbursement and to support the medical necessity of the services provided.

6. Historical Information and Code Maintenance

HCPCS code G9162 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 on December 31, 2019. The termination of this code means that it is no longer valid for billing purposes. 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

As HCPCS code G9162 is no longer active, it is not payable 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. This indicates that the service is either not covered, bundled with other services, or used exclusively by Part A. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS G9162 is not priced separately by Part B or its value is not established.

8. Examples

Here are some examples of scenarios where HCPCS code G9162 would have been used:

1. A patient with a history of language impairment begins a new therapy episode, and the provider assesses their current status in spoken language expression.
2. A child with a speech disorder undergoes regular speech therapy sessions, and the provider documents their progress in spoken language expression at reporting intervals.
3. An adult with aphasia receives language intervention services, and the provider evaluates their functional limitation in spoken language expression during the therapy episode outset.
4. A patient with a traumatic brain injury undergoes speech therapy, and the provider tracks their improvement in spoken language expression over time.
5. A senior citizen with age-related communication difficulties receives language therapy, and the provider assesses their current status in spoken language expression at reporting intervals.