How To Use HCPCS Code G9573

HCPCS code G9573 describes the specific circumstances under which adult patients 18 years of age or older with major depression or dysthymia did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. This code is used to identify patients who have not achieved remission from their depressive symptoms after six months of treatment.

1. What is HCPCS G9573?

HCPCS code G9573 is a specific code used in medical coding to identify adult patients with major depression or dysthymia who did not reach remission at six months. It is important to note that this code is only applicable to patients who meet the specified criteria and have not achieved remission from their depressive symptoms after six months of treatment.

2. Official Description

The official description of HCPCS code G9573 is “Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five.” The short description for this code is “Adl pt md or dys rem 6 mon.”

3. Procedure

1. Patients who meet the criteria of being 18 years of age or older and have been diagnosed with major depression or dysthymia are eligible for this procedure.
2. The provider will assess the patient’s depressive symptoms using the phq-9 or phq-9m scoring system.
3. If the patient’s score is less than five after six months of treatment, indicating that they have not achieved remission, the provider can use HCPCS code G9573 to document this.
4. This code helps in tracking the progress of patients with major depression or dysthymia who require ongoing treatment and monitoring.

4. When to use HCPCS code G9573

HCPCS code G9573 should be used when documenting adult patients with major depression or dysthymia who did not reach remission at six months. It is important to ensure that the patient’s phq-9 or phq-9m score is less than five after the specified time period. This code is not applicable for patients who have achieved remission or for patients who do not meet the specified criteria.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9573, healthcare providers need to ensure that the patient’s medical records clearly indicate the diagnosis of major depression or dysthymia, the use of the phq-9 or phq-9m scoring system, and the patient’s score after six months of treatment. Documentation should also include any additional relevant information, such as the treatment plan and any other interventions provided.

6. Historical Information and Code Maintenance

HCPCS code G9573 was added to the Healthcare Common Procedure Coding System on January 01, 2016. It has an effective date of January 01, 2021, and was terminated on December 31, 2020. The termination of this code indicates that it is no longer in use and should not be billed for services provided after December 31, 2020.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G9573 may vary depending on the specific insurance provider. It is important to check with Medicare or other insurance companies to determine if this code is payable and to understand the pricing and reimbursement policies associated with it.

8. Examples

Here are five examples of when HCPCS code G9573 should be billed:

1. An adult patient diagnosed with major depression who has been receiving treatment for six months but still has a phq-9 score of less than five.
2. A patient with dysthymia who has been undergoing therapy for six months but has not achieved remission based on their phq-9m score.
3. An individual with major depression who has been on medication for six months but continues to experience symptoms, as indicated by their phq-9 score.
4. A patient with dysthymia who has been receiving psychotherapy for six months but has not reached remission according to their phq-9m score.
5. An adult with major depression who has been undergoing a combination of medication and therapy for six months but still has a phq-9 score below five.