How To Use HCPCS Code G9167

HCPCS code G9167 describes the attention given to functional limitation and the discharge status at the time of discharge from therapy or to end reporting. This code is used to indicate the specific circumstances surrounding a patient’s discharge from therapy and the functional limitations they may have experienced during their treatment.

1. What is HCPCS G9167?

HCPCS code G9167 is a specific code used in medical coding to identify the attention given to functional limitation and the discharge status at the time of discharge from therapy or to end reporting. It provides important information about the patient’s condition and the progress made during their therapy sessions.

2. Official Description

The official description of HCPCS code G9167 is “Attention functional limitation, discharge status at discharge from therapy or to end reporting.” This description accurately reflects the purpose of this code, which is to capture the attention given to functional limitations and the discharge status of the patient at the time of their therapy discharge.

3. Procedure

1. The provider should carefully assess the patient’s functional limitations throughout the course of their therapy sessions.
2. At the time of discharge, the provider should document the patient’s functional limitations and their discharge status.
3. The provider should accurately report the attention given to functional limitation and the discharge status using HCPCS code G9167.

4. When to use HCPCS code G9167

HCPCS code G9167 should be used when documenting the attention given to functional limitation and the discharge status at the time of discharge from therapy or to end reporting. It is important to use this code accurately to ensure proper coding and billing for the services provided.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9167, healthcare providers should ensure that the following documentation requirements are met:

• Clear documentation of the patient’s functional limitations throughout the therapy sessions.
• Detailed documentation of the patient’s discharge status at the time of therapy discharge.
• Accurate reporting of the attention given to functional limitation and the discharge status using HCPCS code G9167.

6. Historical Information and Code Maintenance

HCPCS code G9167 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has an effective date of January 1, 2020. This code does not have any maintenance actions associated with it, as indicated by the action code N, which means no maintenance for this code. It is important to stay updated on any changes or revisions to this code to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code G9167 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. It is important to follow the specific guidelines and requirements set forth by Medicare and other insurance providers when billing for services using this code.

8. Examples

Here are five examples of when HCPCS code G9167 should be billed:

1. A patient completes a course of physical therapy for a knee injury and is discharged with improved functional limitations.
2. A patient undergoes occupational therapy for hand rehabilitation and is discharged with no functional limitations.
3. A patient receives speech therapy for language development and is discharged with significant improvement in functional limitations.
4. A patient completes a series of therapy sessions for back pain and is discharged with ongoing functional limitations.
5. A patient undergoes therapy for balance and coordination and is discharged with no functional limitations.