How To Use HCPCS Code G9168

HCPCS code G9168 describes the current status of memory functional limitation at the therapy episode outset and at reporting intervals. This code is used to indicate the level of impairment or limitation in memory function that a patient has at the beginning of a therapy episode and at subsequent reporting intervals. It provides valuable information for healthcare providers to assess and monitor the progress of patients with memory-related conditions.

1. What is HCPCS G9168?

HCPCS code G9168 is specifically used to identify the current status of memory functional limitation at the therapy episode outset and at reporting intervals. It helps healthcare providers to document and track the level of impairment or limitation in memory function for patients receiving therapy services.

2. Official Description

The official description of HCPCS code G9168 is “Memory functional limitation, current status at therapy episode outset and at reporting intervals.” The short description for this code is “Memory current status.”

3. Procedure

1. During the therapy episode outset, the healthcare provider assesses the patient’s memory function and determines the level of impairment or limitation.
2. The provider documents the current status of memory functional limitation in the patient’s medical record.
3. At subsequent reporting intervals, the provider reassesses the patient’s memory function and updates the documentation accordingly.
4. The provider may use various assessment tools or tests to evaluate memory function, such as cognitive tests, memory recall exercises, or patient interviews.
5. Based on the assessment results, the provider assigns the appropriate level of impairment or limitation using the G9168 code.

4. When to use HCPCS code G9168

HCPCS code G9168 should be used when documenting the current status of memory functional limitation at the therapy episode outset and at reporting intervals. It is typically used for patients with memory-related conditions, such as dementia, Alzheimer’s disease, or other cognitive impairments.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9168, healthcare providers need to ensure proper documentation of the patient’s memory functional limitation. This may include detailed notes on the assessment process, the specific memory-related tasks or activities that the patient struggles with, and any relevant diagnostic test results.

6. Historical Information and Code Maintenance

HCPCS code G9168 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has an effective date of January 1, 2020, indicating that it is still currently in use. 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 the services associated with HCPCS code G9168, depending on the specific circumstances and medical necessity. 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 may be bundled or not covered separately. The multiple pricing indicator code is 9, which means 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 G9168 should be billed:

1. A patient with a diagnosis of Alzheimer’s disease undergoes therapy sessions to improve memory function. The provider assesses the patient’s memory functional limitation at the therapy episode outset and at subsequent reporting intervals using code G9168.
2. A patient with a history of traumatic brain injury receives therapy services to address memory impairments. The provider documents the current status of memory functional limitation using code G9168.
3. A patient with cognitive decline due to aging participates in memory rehabilitation therapy. The provider uses code G9168 to track the progress of memory function throughout the therapy sessions.
4. A patient with a diagnosis of mild cognitive impairment undergoes cognitive rehabilitation therapy. The provider assesses and documents the current status of memory functional limitation using code G9168.
5. A patient with memory deficits resulting from a stroke receives therapy services to improve memory function. The provider uses code G9168 to monitor the patient’s memory status over time.