How To Use HCPCS Code G9655

HCPCS code G9655 describes the use of a transfer of care protocol or handoff tool/checklist that includes the required key handoff elements. This code is used to identify and bill for the use of a specific tool or checklist that healthcare providers utilize during the transfer of care process. In this article, we will explore the details of HCPCS code G9655, 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 G9655?

HCPCS code G9655 is a specific code used to identify the use of a transfer of care protocol or handoff tool/checklist that includes the required key handoff elements. This code is essential for accurately documenting and billing for the use of this tool or checklist during the transfer of care process. It allows healthcare providers to track and report on the utilization of this important aspect of patient care.

2. Official Description

The official description of HCPCS code G9655 is “A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used.” The short description for this code is “Toc tool incl key elem.”

3. Procedure

1. During the transfer of care process, the healthcare provider should ensure that a transfer of care protocol or handoff tool/checklist is utilized.
2. The tool or checklist should include all the required key handoff elements, which may include patient information, medical history, current medications, allergies, and any specific instructions or precautions.
3. The healthcare provider should follow the established protocol or use the designated tool/checklist to document and communicate the necessary information during the transfer of care.
4. The tool or checklist should be completed accurately and thoroughly to ensure the safe and effective transfer of care.

4. When to use HCPCS code G9655

HCPCS code G9655 should be used when a transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is utilized during the transfer of care process. This code should be reported for each instance where the tool or checklist is used, ensuring accurate documentation and billing for this important aspect of patient care.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9655, healthcare providers should ensure that the following guidelines and documentation requirements are met:

• The use of the transfer of care protocol or handoff tool/checklist should be clearly documented in the patient’s medical record.
• The completed tool or checklist should be retained as part of the patient’s medical record.
• Any additional documentation related to the transfer of care process, such as communication logs or summaries, should also be included in the medical record.
• When submitting claims for reimbursement, the appropriate HCPCS code G9655 should be included on the claim form.

6. Historical Information and Code Maintenance

HCPCS code G9655 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. The code has remained unchanged since its introduction, providing consistent identification and billing for the use of transfer of care protocols or handoff tool/checklists.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9655 may vary. The pricing indicator code for this code 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. The multiple pricing indicator code is 9, which indicates 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 when HCPCS code G9655 should be billed:

1. A primary care physician completes a transfer of care protocol checklist when referring a patient to a specialist.
2. An emergency department physician utilizes a handoff tool to communicate critical patient information to the receiving hospital during a transfer of care.
3. A nurse uses a transfer of care protocol to ensure all necessary information is communicated when transferring a patient from one unit to another within a hospital.
4. A home healthcare provider completes a handoff checklist when transitioning care from one caregiver to another for a patient receiving ongoing care at home.
5. A pharmacist utilizes a transfer of care protocol to communicate medication changes and instructions to a patient’s primary care physician after a hospital discharge.