How To Use HCPCS Code G9621

HCPCS code G9621 describes the identification of a patient as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method, and the provision of brief counseling. This code is used to indicate that a patient has been identified as having an unhealthy alcohol use and has received counseling to address this issue.

1. What is HCPCS G9621?

HCPCS code G9621 is a specific code used in medical coding to identify patients who have been screened for unhealthy alcohol use and have received brief counseling. It is important for medical coders to accurately assign this code to ensure proper documentation and billing for the services provided.

2. Official Description

The official description of HCPCS code G9621 is “Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling.” The short description for this code is “Scr unheal etoh w/counsel.”

3. Procedure

  1. The healthcare provider begins by conducting a systematic screening for unhealthy alcohol use in the patient.
  2. If the screening indicates that the patient is an unhealthy alcohol user, the provider proceeds to provide brief counseling to address this issue.
  3. The counseling may involve discussing the risks and consequences of unhealthy alcohol use, providing information on resources and support services available for alcohol cessation, and developing a plan for reducing or quitting alcohol consumption.
  4. The provider documents the screening results, counseling provided, and any recommendations or referrals made for further treatment or support.

4. When to use HCPCS code G9621

HCPCS code G9621 should be used when a patient has been screened for unhealthy alcohol use using a systematic screening method and has received brief counseling as a result. It is important to note that this code is specific to the identification of unhealthy alcohol use and the provision of counseling, and should not be used for other alcohol-related services or interventions.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9621, healthcare providers should ensure that the documentation supports the screening for unhealthy alcohol use and the provision of brief counseling. This may include the results of the screening, details of the counseling session, and any recommendations or referrals made. It is important to accurately capture the services provided to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9621 was added to the Healthcare Common Procedure Coding System on January 01, 2016. As of the effective date, 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

Medicare and other insurance providers may cover the services associated with HCPCS code G9621. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service may be bundled or not covered separately. The multiple pricing indicator code is 9, which means that the value for this code is not established. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of scenarios in which HCPCS code G9621 should be billed:

  1. A patient visits their primary care physician for a routine check-up. During the visit, the physician conducts a systematic screening for unhealthy alcohol use and determines that the patient is an unhealthy alcohol user. The physician provides brief counseling to address the issue.
  2. A patient presents to the emergency department with alcohol-related symptoms. As part of the evaluation, the healthcare provider conducts a systematic screening for unhealthy alcohol use and identifies the patient as an unhealthy alcohol user. The provider offers brief counseling to address the issue.
  3. A patient seeks help from a substance abuse counselor for alcohol-related concerns. The counselor conducts a systematic screening for unhealthy alcohol use and determines that the patient is an unhealthy alcohol user. The counselor provides brief counseling to address the issue.
  4. A patient participates in a wellness program that includes alcohol screening and counseling. The program administrator conducts a systematic screening for unhealthy alcohol use and identifies the patient as an unhealthy alcohol user. The administrator provides brief counseling to address the issue.
  5. A patient receives care at a specialized alcohol treatment center. As part of the intake process, the healthcare provider conducts a systematic screening for unhealthy alcohol use and determines that the patient is an unhealthy alcohol user. The provider offers brief counseling to address the issue.

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