How To Use HCPCS Code G9170

HCPCS code G9170 describes the discharge status of a patient with memory functional limitation at the time of discharge from therapy or to end reporting. This code is used to indicate the patient’s condition related to memory function and their status upon completion of therapy or reporting.

1. What is HCPCS G9170?

HCPCS code G9170 is a specific code used in medical coding to identify the memory functional limitation discharge status at the time of discharge from therapy or to end reporting. It provides information about the patient’s memory function and their status after completing therapy or reporting.

2. Official Description

The official description of HCPCS code G9170 is “Memory functional limitation, discharge status at discharge from therapy or to end reporting.” The short description for this code is “Memory d/c status.”

3. Procedure

1. During the patient’s therapy or reporting period, the healthcare provider assesses the patient’s memory function.
2. Upon completion of therapy or reporting, the provider determines the patient’s discharge status related to memory functional limitation.
3. The provider assigns HCPCS code G9170 to indicate the memory functional limitation discharge status at the time of discharge or to end reporting.

4. When to use HCPCS code G9170

HCPCS code G9170 is used when documenting the discharge status of a patient with memory functional limitation at the time of discharge from therapy or to end reporting. It should be used when the patient’s memory function is assessed and their discharge status is determined.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9170, healthcare providers need to document the patient’s memory functional limitation discharge status at the time of discharge from therapy or to end reporting. The documentation should clearly indicate the patient’s memory function assessment and the determined discharge status.

6. Historical Information and Code Maintenance

HCPCS code G9170 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It has a coverage code of C, which indicates that carrier judgment is used for coverage. The code has an action code of N, meaning no maintenance for this code. The code’s action effective date is January 01, 2020. HCPCS code G9170 is not separately priced by Part B and has a pricing indicator code of 00, which means the service is not separately priced. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G9170 may vary. It is important to check with the specific insurance provider to determine if this code is payable. The pricing indicator code of 00 indicates that the service is not separately priced by Part B. Therefore, the reimbursement for this code may depend on the carrier’s judgment and the specific insurance coverage.

8. Examples

Here are five examples of when HCPCS code G9170 should be billed:

1. A patient undergoes memory therapy sessions to improve their memory function. Upon completion of therapy, the provider determines that the patient’s memory functional limitation has improved, and their discharge status is documented as “improved memory function.” HCPCS code G9170 is used to indicate the memory functional limitation discharge status at the time of discharge from therapy.
2. A patient with memory functional limitation completes a reporting period for research purposes. The provider assesses the patient’s memory function and determines their discharge status as “stable memory function.” HCPCS code G9170 is used to indicate the memory functional limitation discharge status at the end of reporting.
3. A patient receives memory therapy sessions, but their memory function does not show significant improvement. The provider determines their discharge status as “persistent memory functional limitation.” HCPCS code G9170 is used to indicate the memory functional limitation discharge status at the time of discharge from therapy.
4. A patient with memory functional limitation completes a reporting period for a clinical trial. The provider assesses the patient’s memory function and determines their discharge status as “worsened memory function.” HCPCS code G9170 is used to indicate the memory functional limitation discharge status at the end of reporting.
5. A patient undergoes memory therapy sessions, and their memory function significantly declines during the therapy period. The provider determines their discharge status as “severe memory functional limitation.” HCPCS code G9170 is used to indicate the memory functional limitation discharge status at the time of discharge from therapy.