How To Use HCPCS Code G9687

HCPCS code G9687 describes hospice services provided to a patient at any time during the measurement period. This code is used to identify and bill for the specific type of care provided by hospice organizations. In this article, we will explore the details of HCPCS code G9687, 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 G9687?

HCPCS code G9687 is used to identify hospice services provided to a patient at any time during the measurement period. It is important to note that this code specifically refers to hospice services and should not be used for other types of care or services. Hospice care is a specialized type of care provided to individuals who are terminally ill and have a life expectancy of six months or less. It focuses on providing comfort and support to patients and their families, rather than attempting to cure the illness.

2. Official Description

The official description of HCPCS code G9687 is “Hospice services provided to patient any time during the measurement period.” The short description for this code is “Hospice anytime msmt per.” This description accurately reflects the purpose of this code, which is to identify and bill for hospice services provided to a patient during the designated measurement period.

3. Procedure

  1. When providing hospice services to a patient, the healthcare provider should ensure that all necessary documentation is completed accurately and thoroughly.
  2. The provider should document the specific services provided, including any medications administered, treatments performed, and any other relevant information.
  3. The provider should also document the start and end dates of the hospice care provided to the patient.
  4. It is important to ensure that all documentation is legible and includes the patient’s identifying information, such as their name and date of birth.
  5. Once the necessary documentation is complete, the provider can use HCPCS code G9687 to bill for the hospice services provided.

4. When to use HCPCS code G9687

HCPCS code G9687 should be used when a healthcare provider has provided hospice services to a patient at any time during the designated measurement period. It is important to note that this code is specific to hospice services and should not be used for other types of care or services. The measurement period may vary depending on the specific requirements of the payer or insurance company, so it is important to follow their guidelines when determining when to use this code.

5. Billing Guidelines and Documentation Requirements

When billing for hospice services using HCPCS code G9687, healthcare providers should ensure that all necessary documentation is completed accurately and thoroughly. This documentation should include details of the services provided, the start and end dates of the hospice care, and any other relevant information. It is important to follow the billing guidelines set forth by the payer or insurance company to ensure proper reimbursement for the services provided.

6. Historical Information and Code Maintenance

HCPCS code G9687 was added to the Healthcare Common Procedure Coding System on January 01, 2017. 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 a pricing indicator code of 00, which indicates that the service is not separately priced by Part B. This means that the service is either not covered, bundled, or used by Part A only. The multiple pricing indicator code for this code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

7. Medicare and Insurance Coverage

HCPCS code G9687 is payable by Medicare and other insurance companies. However, it is important to note that the pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service may be bundled or not covered by Medicare or other insurers. It is important to follow the guidelines and policies set forth by the payer or insurance company when determining coverage and reimbursement for hospice services.

8. Examples

Here are five examples of when HCPCS code G9687 should be billed:

  1. A patient with a terminal illness receives hospice care at home for three months during the measurement period. HCPCS code G9687 should be billed for the hospice services provided.
  2. A patient with a life expectancy of six months or less receives hospice care in a hospice facility for two weeks during the measurement period. HCPCS code G9687 should be billed for the hospice services provided.
  3. A patient with a terminal illness receives hospice care in a nursing home for one month during the measurement period. HCPCS code G9687 should be billed for the hospice services provided.
  4. A patient with a life expectancy of six months or less receives hospice care in a hospital for one week during the measurement period. HCPCS code G9687 should be billed for the hospice services provided.
  5. A patient with a terminal illness receives hospice care in an assisted living facility for four months during the measurement period. HCPCS code G9687 should be billed for the hospice services provided.

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