How To Use HCPCS Code G9691

HCPCS code G9691 describes the provision of hospice services to a patient at any time during the measurement period. This code is used to identify and bill for the specific care and support provided to patients who are receiving hospice care. In this article, we will explore the details of HCPCS code G9691, 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 G9691?

HCPCS code G9691 is used to indicate that a patient has received hospice services 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.

2. Official Description

The official description of HCPCS code G9691 is “Patient had hospice services any time during the measurement period.” The short description for this code is “Pt hosp dur msmt period.”

3. Procedure

  1. When providing hospice services to a patient, the healthcare provider should ensure that all necessary care and support are provided.
  2. This may include pain management, symptom control, emotional support, and assistance with activities of daily living.
  3. The provider should document the specific services provided and the duration of the hospice care during the measurement period.
  4. It is important to accurately record the start and end dates of the hospice services to ensure proper billing and reimbursement.

4. When to use HCPCS code G9691

HCPCS code G9691 should be used when a patient has received hospice services at any time during the measurement period. The measurement period refers to the specific timeframe for which the hospice services were provided.

It is important to note that this code should only be used for patients who have received hospice care and not for other types of care or services.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9691, healthcare providers should ensure that the following documentation requirements are met:

  • Accurate documentation of the start and end dates of the hospice services provided during the measurement period.
  • Documentation of the specific hospice services provided, including pain management, symptom control, emotional support, and assistance with activities of daily living.
  • Proper coding and identification of HCPCS code G9691 on the claim form.

6. Historical Information and Code Maintenance

HCPCS code G9691 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of the effective date, 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 G9691 is covered by Medicare and may be reimbursed by other insurance providers. 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 is bundled or not covered separately.

8. Examples

Here are five examples of when HCPCS code G9691 should be billed:

  1. A patient receives hospice services for pain management and emotional support during the measurement period.
  2. A patient receives hospice services for symptom control and assistance with activities of daily living.
  3. A patient receives hospice services for pain management, symptom control, and emotional support.
  4. A patient receives hospice services for assistance with activities of daily living and emotional support.
  5. A patient receives hospice services for pain management and assistance with activities of daily living.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *