How To Use HCPCS Code G9460

HCPCS code G9460 describes a tobacco assessment or tobacco cessation intervention that was not performed, and the reason for not performing the intervention is not given. This code falls under the category of medical care and is not separately priced by Part B. It was added to the Healthcare Common Procedure Coding System on January 1, 2015, with an effective date of January 1, 2016.

1. What is HCPCS G9460?

HCPCS code G9460 is used to indicate that a tobacco assessment or tobacco cessation intervention was not performed, and the reason for not performing the intervention is not provided. This code is used to capture instances where a healthcare provider did not conduct a tobacco assessment or provide a tobacco cessation intervention, but the specific reason for not doing so is not documented.

2. Official Description

The official description of HCPCS code G9460 is “Tobacco assessment or tobacco cessation intervention not performed, reason not given.” The short description for this code is “No tob assess or cess inter.”

3. Procedure

1. When using HCPCS code G9460, the healthcare provider should document that a tobacco assessment or tobacco cessation intervention was not performed.
2. The specific reason for not performing the intervention should not be provided or documented.
3. The provider should ensure that the documentation accurately reflects the circumstances surrounding the decision not to perform the assessment or intervention.

4. When to use HCPCS code G9460

HCPCS code G9460 should be used when a healthcare provider did not perform a tobacco assessment or provide a tobacco cessation intervention, and the reason for not performing the intervention is not given. This code is applicable in situations where the provider had the opportunity to conduct the assessment or intervention but chose not to, and the reason for this decision is not documented.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9460, healthcare providers should ensure that the documentation clearly indicates that a tobacco assessment or tobacco cessation intervention was not performed. The reason for not performing the intervention should not be provided or documented. It is important to accurately capture the decision not to perform the assessment or intervention without specifying the reason.

6. Historical Information and Code Maintenance

HCPCS code G9460 was added to the Healthcare Common Procedure Coding System on January 1, 2015. It has an effective date of January 1, 2016. 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 G9460 is not separately priced by Part B. It falls under the pricing indicator code 00, which means it is not separately priced by Part B and is not covered or bundled. The multiple pricing indicator code for this code is 9, which indicates that it is not applicable as HCPCS G9460 is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9460 should be billed:

1. A patient visits a healthcare provider for a routine check-up. The provider does not perform a tobacco assessment or provide a tobacco cessation intervention, and the reason for not doing so is not documented.
2. A patient presents with a respiratory condition, and the healthcare provider decides not to perform a tobacco assessment or provide a tobacco cessation intervention. The reason for this decision is not documented.
3. A patient is referred to a specialist for a specific medical condition. The specialist does not perform a tobacco assessment or provide a tobacco cessation intervention, and the reason for not doing so is not documented.
4. A patient visits an urgent care facility for a minor injury. The healthcare provider does not perform a tobacco assessment or provide a tobacco cessation intervention, and the reason for not doing so is not documented.
5. A patient undergoes a surgical procedure. The healthcare provider does not perform a tobacco assessment or provide a tobacco cessation intervention before the surgery, and the reason for not doing so is not documented.