How To Use HCPCS Code G9694

HCPCS code G9694 describes hospice services utilized by a patient at any time during the measurement period. This code is used to identify and bill for the specific hospice services provided to a patient. In this article, we will explore the details of HCPCS code G9694, 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 G9694?

HCPCS code G9694 is used to identify hospice services utilized by a patient at any time during the measurement period. It is important to note that this code specifically refers to hospice services and not other types of healthcare services. The code G9694 is unique to hospice care and is used to accurately document and bill for these services.

2. Official Description

The official description of HCPCS code G9694 is “Hospice services utilized by patient any time during the measurement period.” The short description is “Hosp srv used pt in msmt per.” These descriptions provide a concise summary of the services covered by this code.

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 hospice services provided, including any medications administered, therapies performed, and any other relevant interventions.
  3. The provider should also document the dates and times of the services, as well as the duration of each service.
  4. It is important to ensure that the documentation aligns with the official description of HCPCS code G9694.
  5. Any additional documentation required by Medicare or other insurance providers should also be completed and submitted along with the claim.

4. When to use HCPCS code G9694

HCPCS code G9694 should be used when a patient has utilized hospice services at any time during the measurement period. The measurement period may vary depending on the specific requirements of the payer or insurance provider. It is important to review the guidelines and 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 G9694, healthcare providers should ensure that all necessary documentation is completed and submitted along with the claim. This may include:

  • Documentation of the patient’s eligibility for hospice care
  • Documentation of the specific hospice services provided
  • Documentation of the dates and times of the services
  • Documentation of the duration of each service
  • Any additional documentation required by Medicare or other insurance providers

6. Historical Information and Code Maintenance

HCPCS code G9694 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of the provided information, 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 G9694 may be payable by Medicare and 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 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 review the specific guidelines and coverage policies of Medicare and other insurance providers to determine the reimbursement for hospice services.

8. Examples

Here are five examples of when HCPCS code G9694 should be billed:

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

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