How To Use HCPCS Code G9692

HCPCS code G9692 describes hospice services received by a patient at any time during the measurement period. This code is used to identify and bill for the specific type of care provided to patients who are enrolled in a hospice program. In this article, we will explore the details of HCPCS code G9692, 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 G9692?

HCPCS code G9692 is a specific code used to identify hospice services received by a patient during the measurement period. It is important to note that this code is only applicable to patients who are enrolled in a hospice program and have received hospice care. The code G9692 should be used to accurately document and bill for these services.

2. Official Description

The official description of HCPCS code G9692 is “Hospice services received by patient any time during the measurement period.” The short description for this code is “Hosp recd by pt dur msmt per.” These descriptions provide a clear understanding of the purpose and scope of this code.

3. Procedure

  1. When providing hospice services to a patient, the healthcare provider should ensure that the patient meets the eligibility criteria for hospice care.
  2. The provider should document the specific services provided to the patient during the measurement period.
  3. The services may include medical care, pain management, emotional support, and other necessary interventions to improve the patient’s quality of life.
  4. The provider should accurately document the dates and duration of the hospice services received by the patient.
  5. It is important to ensure that the documentation is complete and supports the medical necessity of the hospice services provided.

4. When to use HCPCS code G9692

HCPCS code G9692 should be used when a patient has received hospice services during the measurement period. This code is applicable to patients who are enrolled in a hospice program and have received care related to their terminal illness. It is important to follow the specific guidelines and eligibility criteria for using this code to ensure accurate billing and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for hospice services using HCPCS code G9692, healthcare providers need to ensure that the documentation supports the medical necessity of the services provided. The documentation should include:

  • Proof of the patient’s enrollment in a hospice program
  • Documentation of the specific services provided during the measurement period
  • Dates and duration of the hospice services received by the patient
  • Supporting medical records and clinical documentation

By following these billing guidelines and providing accurate documentation, healthcare providers can ensure proper reimbursement for the hospice services provided.

6. Historical Information and Code Maintenance

HCPCS code G9692 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 an effective date of January 01, 2017, and has not undergone any significant changes or revisions since its inclusion in the coding system.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover hospice services billed under HCPCS code G9692. 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 separately. The multiple pricing indicator code is 9, which means that the value for this code is not established or not applicable. It is important to verify the coverage and reimbursement policies of specific payers to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code G9692 should be billed:

  1. A patient with a terminal illness receives hospice care at home during the measurement period.
  2. A patient with a terminal illness receives hospice care in a hospice facility during the measurement period.
  3. A patient with a terminal illness receives hospice care in a nursing home during the measurement period.
  4. A patient with a terminal illness receives hospice care in an assisted living facility during the measurement period.
  5. A patient with a terminal illness receives hospice care in a hospital during the measurement period.

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