How To Use HCPCS Code G9646

HCPCS code G9646 describes patients with a 90-day Modified Rankin Scale (MRS) score of 0 to 2. This code is used to identify patients who have minimal to no disability or functional impairment. It is important for medical coders to understand the specific meaning and usage of this code in order to accurately document and bill for the services provided.

1. What is HCPCS G9646?

HCPCS code G9646 is used to identify patients with a 90-day MRS score of 0 to 2. The MRS is a commonly used scale to assess the level of disability or functional impairment in patients who have experienced a stroke or other neurological conditions. A score of 0 indicates no symptoms, while a score of 2 indicates minimal disability with the ability to carry out all usual activities.

2. Official Description

The official description of HCPCS code G9646 is “Patients with 90-day MRS score of 0 to 2.” The short description is “Pt w/90d mrs 0-2.” This description accurately reflects the purpose of the code and helps medical coders identify the appropriate circumstances for its use.

3. Procedure

  1. Patients who meet the criteria of having a 90-day MRS score of 0 to 2 should be identified.
  2. Medical coders should review the patient’s medical records to confirm the MRS score and ensure it falls within the specified range.
  3. The code G9646 should be assigned to the patient’s encounter or claim to indicate their level of disability or functional impairment.

4. When to use HCPCS code G9646

HCPCS code G9646 should be used when documenting and billing for patients who have a 90-day MRS score of 0 to 2. This code is specific to patients with minimal to no disability or functional impairment. It is important to accurately assess and document the patient’s MRS score to ensure the appropriate use of this code.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9646, healthcare providers should ensure that the patient’s medical records clearly indicate their 90-day MRS score. This documentation should be thorough and include any relevant assessments or evaluations that were used to determine the score. When billing for the service, the code G9646 should be included on the claim form to indicate the patient’s level of disability or functional impairment.

6. Historical Information and Code Maintenance

HCPCS code G9646 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. This code has remained unchanged since its inception.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover services or treatments for patients with a 90-day MRS score of 0 to 2, depending on the specific circumstances and medical necessity. However, the pricing indicator code for HCPCS code G9646 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G9646 should be billed:

  1. A patient who had a stroke and has fully recovered with no residual disability.
  2. A patient with a neurological condition who has minimal functional impairment and is able to carry out all usual activities.
  3. A patient who underwent rehabilitation and has achieved a 90-day MRS score of 0 to 2.
  4. A patient with a history of neurological disease who has minimal disability and requires ongoing monitoring and management.
  5. A patient who has experienced a minor head injury and has no neurological deficits.

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