How To Use HCPCS Code G9482

HCPCS code G9482 describes a remote in-home visit for the evaluation and management of a new patient. This code is specifically used in a Medicare-approved CMS Innovation Center demonstration project. The visit is conducted using interactive audio and video technology, allowing for real-time communication between the healthcare provider and the patient. The purpose of this article is to provide a comprehensive understanding of HCPCS code G9482, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS G9482?

HCPCS code G9482 is a unique code used to identify a remote in-home visit for the evaluation and management of a new patient. This code is specifically designated for use in a Medicare-approved CMS Innovation Center demonstration project. The visit is conducted using interactive audio and video technology, allowing for real-time communication between the healthcare provider and the patient. The purpose of this visit is to assess the patient’s medical condition, provide counseling and coordination of care, and address any presenting problem(s) of low to moderate severity.

2. Official Description

The official description of HCPCS code G9482 is as follows: “Remote e/m new pt 20mins.” This description indicates that the code represents a remote evaluation and management (e/m) visit for a new patient, with a duration of 20 minutes. The visit is conducted using interactive audio and video technology, allowing for real-time communication between the healthcare provider and the patient.

3. Procedure

1. The healthcare provider initiates the remote in-home visit using interactive audio and video technology.
2. An expanded problem-focused history is obtained from the patient, which includes gathering information about the patient’s medical background, symptoms, and any relevant medical history.
3. An expanded problem-focused examination is conducted, which may involve observing the patient’s physical appearance, assessing vital signs, and performing any necessary physical examinations remotely.
4. The healthcare provider engages in straightforward medical decision-making based on the information obtained from the history and examination.
5. Counseling and coordination of care with other physicians, qualified healthcare professionals, or agencies are provided as needed, based on the nature of the problem(s) and the needs of the patient or the family.
6. The remote in-home visit typically lasts for 20 minutes, during which the healthcare provider interacts with the patient or family in real-time using interactive audio and video technology.

4. When to use HCPCS code G9482

HCPCS code G9482 should be used in the context of a Medicare-approved CMS Innovation Center demonstration project. This code is specifically designated for remote in-home visits for the evaluation and management of new patients. It is important to ensure that the visit meets the specific requirements outlined in the official description, including an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making. Additionally, the presenting problem(s) should be of low to moderate severity.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9482, healthcare providers should ensure that the visit meets the specific criteria outlined in the official description. Documentation should include a detailed record of the expanded problem-focused history, expanded problem-focused examination, and straightforward medical decision-making. Additionally, any counseling and coordination of care provided should be clearly documented. It is important to follow the billing guidelines and documentation requirements set forth by Medicare and other insurance providers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9482 was added to the Healthcare Common Procedure Coding System on April 01, 2016. As of January 01, 2018, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important to stay updated on any changes or revisions to HCPCS codes to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code G9482 is covered by Medicare when used in the context of a Medicare-approved CMS Innovation Center demonstration project. 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 is bundled or not covered by Medicare. The multiple pricing indicator code is 9, which indicates that the code is not applicable as HCPCS is not priced separately by Part B or the value is not established. It is important to verify coverage and reimbursement policies with Medicare and other insurance providers to ensure accurate billing and reimbursement.

8. Examples

Here are five examples of scenarios in which HCPCS code G9482 may be billed:

1. A healthcare provider conducts a remote in-home visit for a new patient using interactive audio and video technology. The visit lasts for 20 minutes, during which an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making are performed. Counseling and coordination of care are provided as needed.
2. A patient with a low to moderate severity medical condition requests a remote in-home visit for evaluation and management. The healthcare provider conducts the visit using interactive audio and video technology, following the specific requirements outlined in the official description of HCPCS code G9482.
3. A healthcare provider participates in a Medicare-approved CMS Innovation Center demonstration project and conducts a remote in-home visit for a new patient. The visit includes an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making, all performed using interactive audio and video technology.
4. A patient residing in a remote area seeks medical evaluation and management services. The healthcare provider conducts a remote in-home visit using interactive audio and video technology, following the specific requirements outlined in the official description of HCPCS code G9482.
5. A healthcare provider conducts a remote in-home visit for a new patient who requires counseling and coordination of care with other physicians or qualified healthcare professionals. The visit is conducted in real-time using interactive audio and video technology, with a duration of 20 minutes.