How To Use HCPCS Code G9380

HCPCS code G9380 describes the provision of assistance to patients with end-of-life issues or the review and update of existing end-of-life plans during the measurement period. This code is used to identify and document the support and guidance offered to patients in addressing their end-of-life concerns and ensuring that their plans align with their current needs and preferences.

1. What is HCPCS G9380?

HCPCS code G9380 is a specific code used in medical coding to indicate that a patient has been offered assistance with end-of-life issues or that their existing end-of-life plan has been reviewed or updated during the measurement period. This code serves as a way to document and track the provision of support and guidance to patients in addressing their end-of-life concerns.

2. Official Description

The official description of HCPCS code G9380 is “Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period.” The short description for this code is “Off assis eol iss.”

3. Procedure

1. The healthcare provider initiates a conversation with the patient regarding their end-of-life concerns and plans.
2. The provider offers assistance and guidance to the patient in addressing their end-of-life issues, such as discussing advance care planning, hospice care, or palliative care options.
3. If the patient already has an existing end-of-life plan, the provider reviews and updates it based on the patient’s current needs and preferences.
4. The provider documents the details of the assistance provided or the review and update of the end-of-life plan in the patient’s medical record.

4. When to use HCPCS code G9380

HCPCS code G9380 should be used when a healthcare provider offers assistance to a patient with end-of-life issues or reviews and updates an existing end-of-life plan during the measurement period. This code is applicable when the provider engages in discussions and activities related to end-of-life care and ensures that the patient’s plan aligns with their current needs and preferences.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9380, healthcare providers need to document the details of the assistance provided or the review and update of the end-of-life plan in the patient’s medical record. This documentation should include the nature of the assistance offered, any discussions held, and any changes made to the existing plan. It is essential to maintain accurate and comprehensive documentation to support the medical necessity of the service.

6. Historical Information and Code Maintenance

HCPCS code G9380 was added to the Healthcare Common Procedure Coding System on January 01, 2015. The code’s long description or modifier code was changed, indicating a revision in the code’s description. The revised long description reflects the specific nature of the assistance provided or the review and update of the end-of-life plan. As of January 01, 2024, this code’s action effective date is set, indicating that it will remain in use with the current description and guidelines.

7. Medicare and Insurance Coverage

HCPCS code G9380 is subject to Medicare coverage and reimbursement policies. The pricing indicator code for this code is 00, which means that the service is not separately priced by Medicare Part B. This indicates that the service is either bundled with other services or not covered by Medicare. The multiple pricing indicator code is 9, which means that the value for this code is not established, as indicated by the pricing indicator being ’99’ or not applicable. It is important for healthcare providers to verify coverage and reimbursement policies with Medicare or other insurance carriers.

8. Examples

Here are five examples of scenarios where HCPCS code G9380 may be billed:

1. A patient with a terminal illness seeks guidance from their healthcare provider regarding end-of-life care options. The provider offers assistance in exploring hospice care and discusses advance care planning.
2. A patient with an existing end-of-life plan requests a review and update due to changes in their health condition. The provider reviews the plan, makes necessary adjustments, and documents the changes in the patient’s medical record.
3. A healthcare provider initiates a conversation with a patient about their end-of-life concerns and offers support in discussing their preferences for palliative care. The provider documents the details of the conversation and any recommendations made.
4. A patient’s family member requests assistance from the healthcare provider in understanding the options available for end-of-life care. The provider offers guidance and resources to help the family make informed decisions.
5. A patient expresses concerns about their end-of-life wishes during a routine check-up. The provider engages in a discussion, addresses the patient’s concerns, and documents the conversation in the medical record.