How To Use HCPCS Code G9174

HCPCS code G9174 describes a specific speech language pathology functional limitation and is used to indicate the current status of the patient at the therapy episode outset and at reporting intervals. This code was terminated on December 31, 2019, and is no longer in use. It falls under the category of “Other speech language pathology functional limitation” and is classified as a medical care service.

1. What is HCPCS G9174?

HCPCS code G9174 is a unique alphanumeric code that is used to identify a specific speech language pathology functional limitation. It provides information about the current status of the patient at the beginning of the therapy episode and at reporting intervals. This code is no longer active and was terminated on December 31, 2019.

2. Official Description

The official description of HCPCS code G9174 is “Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals.” The short description for this code is “Speech lang current status.”

3. Procedure

1. During the therapy episode outset, the speech language pathologist assesses the patient’s current status in terms of speech and language pathology functional limitation.
2. The speech language pathologist continues to monitor and evaluate the patient’s progress at regular reporting intervals.
3. Documentation of the patient’s current status and any changes in their functional limitation should be recorded accurately.
4. The speech language pathologist may use various assessment tools and techniques to gather information about the patient’s speech and language abilities.
5. Based on the assessment, the speech language pathologist develops a treatment plan tailored to the patient’s specific needs.

4. When to use HCPCS code G9174

HCPCS code G9174 is used when documenting the current status of a patient’s speech language pathology functional limitation at the therapy episode outset and at reporting intervals. It is important to use this code accurately and only when it aligns with the specific context and criteria outlined by the healthcare provider or payer.

5. Billing Guidelines and Documentation Requirements

When billing for services related to HCPCS code G9174, healthcare providers should ensure that the documentation accurately reflects the patient’s current status and any changes in their speech language pathology functional limitation. It is important to provide detailed and specific information to support the medical necessity of the services rendered.

6. Historical Information and Code Maintenance

HCPCS code G9174 was added to the Healthcare Common Procedure Coding System on January 01, 2013. It was terminated on December 31, 2019. 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

Medicare and other insurance coverage for HCPCS code G9174 may vary. It is important to consult with the specific payer to determine if this code is payable and to understand the pricing and coverage guidelines. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS G9174 is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9174 may be used:

1. A patient with a speech language pathology functional limitation undergoes an initial assessment at the therapy episode outset to determine their current status.
2. At a reporting interval, the speech language pathologist evaluates the progress of a patient with a speech language pathology functional limitation and documents any changes in their current status.
3. A patient with a speech language pathology functional limitation receives therapy services, and their current status is assessed and documented at the beginning of each therapy session.
4. During a therapy episode, a patient with a speech language pathology functional limitation undergoes periodic evaluations to track their progress and adjust the treatment plan accordingly.
5. A speech language pathologist provides ongoing therapy services to a patient with a speech language pathology functional limitation and regularly documents their current status to monitor their progress.