How To Use HCPCS Code G9714

HCPCS code G9714 describes the situation where a patient is utilizing hospice services at any time during the measurement period. This code is used to indicate that the patient is under the care of a hospice program, which provides specialized medical care, emotional support, and pain management for individuals who are terminally ill.

1. What is HCPCS G9714?

HCPCS code G9714 is specifically used to identify patients who are receiving hospice services during the measurement period. It is important to note that this code should only be used when the patient is actively utilizing hospice care.

2. Official Description

The official description for HCPCS code G9714 is “Patient is using hospice services any time during the measurement period.” The short description for this code is “Pt is w/hosp during msmt per.”

3. Procedure

  1. When using HCPCS code G9714, the healthcare provider should ensure that the patient meets the criteria for hospice care. This typically includes having a terminal illness with a life expectancy of six months or less.
  2. The provider should document the start and end dates of the measurement period during which the patient is utilizing hospice services.
  3. The provider should also document the specific hospice services being provided to the patient, such as pain management, counseling, and assistance with activities of daily living.
  4. It is important to accurately report the dates and duration of hospice care to ensure proper reimbursement and continuity of care for the patient.

4. When to use HCPCS code G9714

HCPCS code G9714 should be used when a patient is actively receiving hospice services during the measurement period. This code is not applicable for patients who are not utilizing hospice care or for services provided outside of the measurement period.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9714, healthcare providers should ensure that the following documentation requirements are met:

  • Documentation of the patient’s terminal illness and prognosis
  • Documentation of the start and end dates of the measurement period
  • Documentation of the specific hospice services provided to the patient

Providers should also follow the billing guidelines set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement for hospice services.

6. Historical Information and Code Maintenance

HCPCS code G9714 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

Medicare and other insurance carriers may provide coverage for hospice services under HCPCS code G9714. However, it is important to review the specific coverage guidelines and policies of each insurance carrier to ensure proper reimbursement.

8. Examples

Here are five examples of when HCPCS code G9714 should be billed:

  1. A patient with terminal cancer is receiving pain management and emotional support from a hospice program during the measurement period.
  2. An elderly patient with end-stage heart failure is under the care of a hospice program, receiving assistance with activities of daily living and medication management.
  3. A patient with advanced Alzheimer’s disease is receiving specialized care and support from a hospice program.
  4. A terminally ill child is receiving palliative care and counseling from a hospice program.
  5. A patient with end-stage renal disease is receiving hospice services to manage pain and provide emotional support during the measurement period.

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