How To Use HCPCS Code G9642

HCPCS code G9642 describes the status of a patient as a current smoker, indicating that they are actively engaged in smoking cigarettes, cigars, pipes, e-cigarettes, or marijuana. This code is used to capture and document the smoking habits of patients for medical and billing purposes. In this article, we will explore the details of HCPCS code G9642, 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 G9642?

HCPCS code G9642 is used to identify patients who are currently smoking. It serves as a means of documenting the smoking habits of patients for medical and billing purposes. The code specifically covers various forms of smoking, including cigarettes, cigars, pipes, e-cigarettes, and marijuana.

2. Official Description

The official description of HCPCS code G9642 is “Current smoker (e.g., cigarette, cigar, pipe, e-cigarette or marijuana).” The short description for this code is “Current smoker.”

3. Procedure

  1. The procedure for using HCPCS code G9642 involves assessing the patient’s smoking habits during a medical encounter.
  2. The healthcare provider should inquire about the patient’s smoking history and determine if they are currently smoking any of the mentioned substances.
  3. If the patient confirms their status as a current smoker, the provider should document this information in the patient’s medical record.
  4. The code G9642 can then be assigned to accurately reflect the patient’s smoking status.

4. When to use HCPCS code G9642

HCPCS code G9642 should be used when a patient is identified as a current smoker during a medical encounter. This code is applicable for patients who engage in smoking cigarettes, cigars, pipes, e-cigarettes, or marijuana. It is important to accurately document the patient’s smoking habits to ensure proper medical management and billing.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9642, healthcare providers need to document the patient’s smoking status and the specific substance they are currently smoking. This information should be clearly recorded in the patient’s medical record. When billing for services or supplies related to the patient’s smoking status, the code G9642 should be included on the claim form to indicate the patient’s current smoker status.

6. Historical Information and Code Maintenance

HCPCS code G9642 was added to the Healthcare Common Procedure Coding System on January 01, 2016. As of the effective date of January 01, 2021, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its addition to the HCPCS.

7. Medicare and Insurance Coverage

HCPCS code G9642 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered as a separate service. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS code G9642 is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9642 should be billed:

  1. A patient presents for a routine check-up, and during the assessment, they disclose that they are currently smoking cigarettes.
  2. A physician conducts a pre-operative evaluation and discovers that the patient is a current smoker of e-cigarettes.
  3. A healthcare provider performs a respiratory assessment on a patient and documents that they are currently smoking cigars.
  4. A patient visits a primary care physician for a follow-up appointment, and it is noted in their medical record that they are actively smoking marijuana.
  5. During a counseling session, a patient reveals that they are currently smoking a pipe, which is documented by the healthcare provider.

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