How To Use HCPCS Code G9402

HCPCS code G9402 describes the follow-up care provided to a patient within 30 days after discharge. This code is used to indicate that the patient received necessary medical attention and monitoring after being discharged from a healthcare facility. In this article, we will explore the details of HCPCS code G9402, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G9402?

HCPCS code G9402 is used to identify the follow-up care provided to a patient within 30 days after discharge. It signifies that the patient received necessary medical attention and monitoring to ensure their well-being after leaving a healthcare facility.

2. Official Description

The official description of HCPCS code G9402 is “Patient received follow-up within 30 days after discharge.” The short description for this code is “Recd f/u w/in 30d disch.”

3. Procedure

1. The provider initiates the follow-up care process within 30 days after the patient’s discharge.
2. They review the patient’s medical records, including the discharge summary, to understand the reason for the initial hospitalization and any specific instructions provided.
3. The provider may conduct a physical examination to assess the patient’s current health status and identify any potential complications or issues.
4. They may order diagnostic tests or laboratory work to monitor the patient’s progress and ensure that their condition is improving.
5. Based on the findings, the provider may prescribe medications, adjust treatment plans, or recommend further interventions.
6. The provider documents the follow-up care provided, including any changes in the patient’s condition, treatment modifications, and recommendations for future care.

4. When to use HCPCS code G9402

HCPCS code G9402 should be used when a patient receives follow-up care within 30 days after being discharged from a healthcare facility. It is important to note that this code is specific to the follow-up care provided and does not encompass the initial hospitalization or any other services rendered during the patient’s stay.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9402, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation of the patient’s discharge from a healthcare facility.
• Documentation of the follow-up care provided within 30 days after discharge.
• Details of any diagnostic tests, laboratory work, medications, treatment modifications, or recommendations made during the follow-up care.

6. Historical Information and Code Maintenance

HCPCS code G9402 was added to the Healthcare Common Procedure Coding System on January 01, 2015. As of the effective date of January 01, 2021, 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

HCPCS code G9402 may be covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare. The multiple pricing indicator code is 9, which signifies that the value for this code is not established. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of scenarios where HCPCS code G9402 should be billed:

1. A patient is discharged from a hospital after undergoing surgery. Within 30 days, they visit their primary care physician for a follow-up appointment to assess their recovery progress and address any concerns.
2. A patient is discharged from a rehabilitation facility after completing a program for physical therapy. Within 30 days, they have a follow-up appointment with their therapist to monitor their functional improvement and adjust their treatment plan if necessary.
3. A patient is discharged from a psychiatric hospital after receiving treatment for a mental health condition. Within 30 days, they have a follow-up appointment with their psychiatrist to evaluate their medication regimen and discuss any ongoing therapy needs.
4. A patient is discharged from a skilled nursing facility after recovering from a severe illness. Within 30 days, they visit their primary care physician for a follow-up visit to ensure their condition remains stable and to address any ongoing care needs.
5. A patient is discharged from a cardiac care unit after undergoing a cardiac procedure. Within 30 days, they have a follow-up appointment with their cardiologist to assess their cardiac function and adjust their medication regimen if necessary.