How To Use HCPCS Code G9518

HCPCS code G9518 describes the documentation of active injection drug use. This code is used to indicate that a healthcare provider has documented the active injection drug use of a patient. In this article, we will explore the details of HCPCS code G9518, 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 G9518?

HCPCS code G9518 is used to identify the documentation of active injection drug use. It is important for healthcare providers to accurately document this information in the patient’s medical record to ensure appropriate care and treatment.

2. Official Description

The official description of HCPCS code G9518 is “Documentation of active injection drug use.” The short description is “Doc active inj drug use.”

3. Procedure

1. During the patient encounter, the healthcare provider should inquire about the patient’s history of active injection drug use.
2. If the patient confirms active injection drug use, the provider should document this information in the patient’s medical record.
3. The documentation should include details such as the type of drugs used, frequency of use, and any associated complications or health issues.
4. It is important for the provider to maintain confidentiality and create a non-judgmental environment to encourage honest disclosure from the patient.

4. When to use HCPCS code G9518

HCPCS code G9518 should be used when a healthcare provider has documented the active injection drug use of a patient. It is important to use this code accurately and only when the documentation is present in the medical record.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9518, healthcare providers need to ensure that the documentation of active injection drug use is clearly stated in the patient’s medical record. This documentation should include relevant details such as the type of drugs used, frequency of use, and any associated complications or health issues.

6. Historical Information and Code Maintenance

HCPCS code G9518 was added to the Healthcare Common Procedure Coding System on January 01, 2016. Since its addition, 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

The coverage of HCPCS code G9518 may vary depending on the carrier’s judgment. It is important for healthcare providers to check with Medicare or other insurance providers to determine if this code is payable. 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 the value is not established.

8. Examples

Here are five examples of when HCPCS code G9518 should be billed:

1. A patient presents to the emergency department with an abscess at an injection site, and the healthcare provider documents the patient’s active injection drug use.
2. A primary care physician conducts a routine check-up and discovers needle track marks on the patient’s arms. The provider documents the patient’s active injection drug use.
3. A psychiatrist evaluates a patient with a history of substance abuse and documents the patient’s current active injection drug use.
4. A nurse practitioner performs a comprehensive assessment on a patient seeking addiction treatment and documents the patient’s active injection drug use.
5. A pain management specialist prescribes medication to a patient with a history of active injection drug use and documents this information in the patient’s medical record.