How To Use HCPCS Code G9681

HCPCS code G9681 describes the onsite acute care treatment of a resident with chronic obstructive pulmonary disease (COPD) or asthma. This code can only be billed once per day per beneficiary. In this article, we will explore the details of HCPCS code G9681, 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 G9681?

HCPCS code G9681 is used to identify the onsite acute care treatment of a resident with COPD or asthma. It is important to note that this code can only be billed once per day per beneficiary. The purpose of this code is to accurately document and bill for the specific treatment provided to patients with COPD or asthma in an acute care setting.

2. Official Description

The official description of HCPCS code G9681 is “Acute care chronic obstruct.” The short description is “Acute care chronic obstruct.”

3. Procedure

1. Upon identifying a resident with COPD or asthma in need of acute care treatment, the healthcare provider assesses the patient’s condition and determines the appropriate course of action.
2. The provider administers the necessary treatment, which may include medication administration, oxygen therapy, breathing exercises, or other interventions aimed at managing the acute symptoms of COPD or asthma.
3. The provider closely monitors the patient’s response to treatment and adjusts the interventions as needed to ensure optimal care.
4. Documentation of the treatment provided, including the specific interventions performed, the patient’s response, and any additional instructions or recommendations, is essential for accurate billing and continuity of care.

4. When to use HCPCS code G9681

HCPCS code G9681 should be used when providing onsite acute care treatment to a resident with COPD or asthma. It is important to note that this code can only be billed once per day per beneficiary. Therefore, if multiple acute care treatments are provided on the same day to the same beneficiary, only one instance of HCPCS code G9681 should be reported.

5. Billing Guidelines and Documentation Requirements

When billing for the onsite acute care treatment of a resident with COPD or asthma using HCPCS code G9681, healthcare providers need to ensure proper documentation of the following:

• Identification of the resident with COPD or asthma
• Description of the acute care treatment provided
• Monitoring and assessment of the patient’s response to treatment
• Any additional interventions or adjustments made during the acute care session

Accurate and detailed documentation is crucial for proper billing and reimbursement. It helps demonstrate the medical necessity of the treatment and ensures compliance with coding and billing guidelines.

6. Historical Information and Code Maintenance

HCPCS code G9681 was added to the Healthcare Common Procedure Coding System on October 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.

7. Medicare and Insurance Coverage

HCPCS code G9681 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 separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS code G9681 is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9681 should be billed:

1. A resident with COPD experiences an acute exacerbation and requires immediate onsite treatment to manage the symptoms.
2. An asthma patient residing in a healthcare facility develops severe breathing difficulties and needs acute care intervention.
3. A resident with COPD experiences a sudden decrease in oxygen saturation levels and requires immediate onsite treatment to stabilize their condition.
4. An asthma patient in a long-term care facility develops a severe asthma attack and needs acute care treatment to alleviate the symptoms.
5. A resident with COPD experiences a sudden increase in respiratory distress and requires immediate onsite intervention to prevent further complications.