How To Use HCPCS Code G9652

HCPCS code G9652 describes the treatment of a patient with a systemic or biologic medication for psoriasis for at least six months. This code is used to identify and bill for the specific treatment provided to patients with psoriasis who have undergone a minimum of six months of systemic or biologic medication therapy.

1. What is HCPCS G9652?

HCPCS code G9652 is a specific code used in medical coding to identify and bill for the treatment of patients with psoriasis who have been treated with a systemic or biologic medication for at least six months. This code helps healthcare providers and insurance companies accurately document and track the treatment provided to patients with psoriasis.

2. Official Description

The official description of HCPCS code G9652 is “Patient has been treated with a systemic or biologic medication for psoriasis for at least six months.” The short description for this code is “Pt tx sys bio med psori 6mth.” This description clearly indicates that the code is used to identify patients who have undergone a specific treatment regimen for psoriasis using systemic or biologic medications for a minimum of six months.

3. Procedure

1. Assess the patient’s medical history and confirm the diagnosis of psoriasis.
2. Determine the appropriate systemic or biologic medication for the patient’s psoriasis treatment.
3. Administer the selected medication to the patient as per the prescribed dosage and frequency.
4. Monitor the patient’s response to the medication and adjust the treatment plan if necessary.
5. Continue the treatment for a minimum of six months, ensuring regular follow-up visits and assessments.

4. When to use HCPCS code G9652

HCPCS code G9652 should be used when documenting and billing for the treatment of patients with psoriasis who have been treated with a systemic or biologic medication for at least six months. This code is specifically used to identify and track the duration of treatment for psoriasis patients and is not applicable for patients who have not completed the minimum six-month treatment period.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9652, healthcare providers need to ensure accurate and detailed documentation of the patient’s psoriasis diagnosis, the specific systemic or biologic medication used, the duration of treatment (minimum of six months), and any relevant follow-up visits or assessments. This documentation is essential for proper billing and reimbursement purposes.

6. Historical Information and Code Maintenance

HCPCS code G9652 was added to the Healthcare Common Procedure Coding System on January 01, 2016. It has an effective date of January 01, 2017. As of December 31, 2016, this code has been terminated. The termination of this code indicates that it is no longer in use for billing and documentation purposes.

7. Medicare and Insurance Coverage

The coverage and reimbursement for HCPCS code G9652 may vary depending on the specific insurance provider and policy. It is important for healthcare providers to verify the coverage and reimbursement policies of Medicare and other insurance companies to ensure proper billing and reimbursement for the treatment provided using this code.

8. Examples

Here are five examples of scenarios where HCPCS code G9652 would be used:

1. Example 1: A patient with psoriasis has been receiving treatment with a systemic medication for seven months. HCPCS code G9652 would be used to bill for the treatment provided.
2. Example 2: A patient with psoriasis has completed six months of treatment with a biologic medication. HCPCS code G9652 would be used to document and bill for the treatment.
3. Example 3: A patient with psoriasis has been treated with a systemic medication for four months. HCPCS code G9652 would not be used in this case, as the minimum treatment duration of six months has not been met.
4. Example 4: A patient with psoriasis has been treated with a biologic medication for eight months. HCPCS code G9652 would be used to accurately document and bill for the treatment provided.
5. Example 5: A patient with psoriasis has completed six months of treatment with a combination of systemic and biologic medications. HCPCS code G9652 would be used to indicate the duration of treatment and bill accordingly.