How To Use HCPCS Code G9718

HCPCS code G9718 describes hospice services provided to a patient at any time during the measurement period. This code is used to identify and bill for the specific services rendered in a hospice setting. In this article, we will delve into the details of HCPCS code G9718, 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 G9718?

HCPCS code G9718 is used to identify hospice services provided to a patient at any time during the measurement period. It is important to note that this code is specific to hospice services and should not be used for other types of medical care or procedures. The code G9718 is unique to hospice services and allows for accurate billing and reimbursement for these services.

2. Official Description

The official description of HCPCS code G9718 is “Hospice services for patient provided any time during the measurement period.” This description clearly indicates that this code is used to identify and bill for hospice services provided to a patient within a specific measurement period.

3. Procedure

  1. When providing hospice services to a patient, ensure that all necessary documentation is completed accurately and thoroughly.
  2. Include the patient’s medical history, diagnosis, and any relevant information regarding the need for hospice care.
  3. Document the specific services provided during the measurement period, including any medications administered, therapies performed, and any other relevant interventions.
  4. Ensure that all documentation is compliant with the requirements set forth by the healthcare facility and any applicable regulatory bodies.
  5. Submit the appropriate claim using HCPCS code G9718 to accurately bill for the hospice services provided.

4. When to use HCPCS code G9718

HCPCS code G9718 should be used when providing hospice services to a patient at any time during the measurement period. It is important to note that this code is specific to hospice services and should not be used for other types of medical care or procedures. The measurement period may vary depending on the specific guidelines and requirements set forth by the healthcare facility or insurance provider.

5. Billing Guidelines and Documentation Requirements

When billing for hospice services using HCPCS code G9718, healthcare providers need to ensure that all necessary documentation is completed accurately and thoroughly. This includes documenting the patient’s medical history, diagnosis, and any relevant information regarding the need for hospice care. Additionally, providers should document the specific services provided during the measurement period, including any medications administered, therapies performed, and any other relevant interventions. It is crucial to comply with the documentation requirements set forth by the healthcare facility and any applicable regulatory bodies to ensure accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9718 was added to the Healthcare Common Procedure Coding System on January 01, 2017. It has an effective date of January 01, 2023. As of December 31, 2022, this code is terminated and no longer in use. The termination of this code indicates that it is no longer valid for billing purposes after the specified date. It is important for healthcare providers to stay updated on code maintenance actions to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9718 may vary depending on the specific policies and guidelines set forth by each provider. It is important for healthcare providers to verify coverage and reimbursement policies with the respective insurance companies or Medicare to ensure accurate billing and reimbursement. The pricing indicator code for HCPCS code G9718 is 00, which indicates that the service is not separately priced by Part B. This means that the service is either not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which means that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9718 should be billed:

  1. A patient with a terminal illness receives hospice services at home during the measurement period.
  2. A patient with a life-limiting condition receives hospice services in a hospice facility throughout the measurement period.
  3. A patient with a terminal illness receives hospice services in a nursing home during the measurement period.
  4. A patient with a life-limiting condition receives hospice services in an assisted living facility throughout the measurement period.
  5. A patient with a terminal illness receives hospice services in a hospital setting during the measurement period.

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