How To Use HCPCS Code G9693

HCPCS code G9693 describes the patient’s use of hospice services at any time during the measurement period. This code is used to indicate that a patient has received hospice care during a specific timeframe. In this article, we will explore the details of HCPCS code G9693, 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 G9693?

HCPCS code G9693 is used to identify the patient’s use of hospice services during the measurement period. It signifies that the patient has received care from a hospice provider at any time within the specified timeframe. This code helps in tracking and documenting the utilization of hospice services by patients.

2. Official Description

The official description of HCPCS code G9693 is “Patient use of hospice services any time during the measurement period.” The short description for this code is “Pt use hosp during msmt per.” These descriptions accurately convey the purpose and meaning of the code.

3. Procedure

  1. During the measurement period, the healthcare provider should document the patient’s use of hospice services.
  2. This includes any care or services provided by a hospice provider, such as palliative care, pain management, emotional support, and assistance with activities of daily living.
  3. The provider should ensure that the documentation clearly indicates the dates and duration of the hospice services received by the patient.
  4. It is important to accurately record the patient’s utilization of hospice services to ensure proper billing and reimbursement.

4. When to use HCPCS code G9693

HCPCS code G9693 should be used when a patient has received hospice services at any time during the measurement period. The measurement period is a specific timeframe determined by the healthcare provider or payer, and it may vary depending on the context or purpose of the measurement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9693, healthcare providers need to ensure that the documentation supports the patient’s use of hospice services during the measurement period. The documentation should include:

  • The dates and duration of the hospice services provided
  • Details of the specific hospice services rendered, such as palliative care, pain management, emotional support, and assistance with activities of daily living
  • Any other relevant information that demonstrates the patient’s utilization of hospice services

Providers should follow the billing guidelines set forth by the payer or Medicare to ensure accurate and timely reimbursement for the services provided.

6. Historical Information and Code Maintenance

HCPCS code G9693 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 remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code G9693 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 G9693 is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9693 should be billed:

  1. A patient with a terminal illness receives hospice care for pain management and emotional support during the measurement period.
  2. An elderly patient with a chronic condition receives palliative care from a hospice provider throughout the measurement period.
  3. A patient with a life-limiting illness receives assistance with activities of daily living from a hospice provider for a portion of the measurement period.
  4. A terminally ill patient receives hospice services for pain management and symptom control during the measurement period.
  5. A patient with a terminal diagnosis receives emotional and spiritual support from a hospice provider throughout the measurement period.

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