How To Use HCPCS Code G9523

HCPCS code G9523 describes a specific situation in which a patient has been discontinued from hemodialysis or peritoneal dialysis. This code is used to indicate that the patient is no longer receiving these forms of dialysis treatment. In this article, we will explore the details of HCPCS code G9523, 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 G9523?

HCPCS code G9523 is used to identify patients who have been discontinued from hemodialysis or peritoneal dialysis. It signifies that the patient is no longer undergoing these specific forms of dialysis treatment. This code is important for accurately documenting and billing for the patient’s healthcare services.

2. Official Description

The official description of HCPCS code G9523 is “Patient discontinued from hemodialysis or peritoneal dialysis.” The short description is “D/c hemo or perit dialysis.” This description clearly indicates that the code is used to denote the termination of hemodialysis or peritoneal dialysis for a patient.

3. Procedure

1. When a patient is discontinued from hemodialysis or peritoneal dialysis, the healthcare provider should document the date of discontinuation.
2. The provider should also include any relevant information regarding the reason for discontinuation, such as a change in the patient’s medical condition or the completion of a prescribed treatment course.
3. It is important to accurately record the details of the patient’s discontinuation from dialysis to ensure proper documentation and billing.

4. When to use HCPCS code G9523

HCPCS code G9523 should be used when a patient has been discontinued from hemodialysis or peritoneal dialysis. This code is applicable in situations where the patient is no longer receiving these specific forms of dialysis treatment. It is important to use this code accurately to reflect the patient’s current status and to ensure proper billing for the healthcare services provided.

5. Billing Guidelines and Documentation Requirements

When billing for services related to HCPCS code G9523, healthcare providers should ensure that the following documentation requirements are met:

• Include the date of discontinuation of hemodialysis or peritoneal dialysis.
• Provide a clear and concise description of the reason for discontinuation.
• Ensure that all relevant medical records and supporting documentation are available for review, if necessary.

By meeting these billing guidelines and documentation requirements, healthcare providers can accurately bill for the services provided to patients who have been discontinued from hemodialysis or peritoneal dialysis.

6. Historical Information and Code Maintenance

HCPCS code G9523 was added to the Healthcare Common Procedure Coding System on January 1, 2016. It has an effective date of January 1, 2021. As of December 31, 2020, this code was terminated. The termination of this code indicates that it is no longer in use for billing purposes.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9523 may vary. It is important for healthcare providers to review the specific coverage policies of each payer to determine if this code is payable. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the code is not applicable for separate pricing by Part B or that the value is not established.

8. Examples

Here are some examples of when HCPCS code G9523 should be billed:

1. A patient who has been receiving hemodialysis for several months decides to discontinue the treatment due to improved kidney function.
2. A patient who has been undergoing peritoneal dialysis is transitioned to a kidney transplant and is no longer in need of dialysis.
3. A patient who has been receiving hemodialysis is transferred to a different healthcare facility that offers a different form of dialysis treatment.
4. A patient who has been undergoing peritoneal dialysis is no longer able to continue the treatment due to a medical condition that contraindicates its use.
5. A patient who has been receiving hemodialysis is enrolled in a clinical trial for an alternative treatment modality and is discontinued from dialysis as part of the trial protocol.