How To Use HCPCS Code G9719

HCPCS code G9719 describes the condition of a patient who is not ambulatory, bedridden, immobile, confined to a chair, wheelchair-bound, dependent on a helper pushing the wheelchair, independent in a wheelchair, or requires minimal help in a wheelchair. This code is used to identify patients who have limited mobility and require assistance or aids for movement.

1. What is HCPCS G9719?

HCPCS code G9719 is used to indicate the specific condition of a patient who is unable to ambulate, immobile, or dependent on a wheelchair for mobility. It is important to accurately assign this code to ensure proper documentation and billing for the patient’s condition.

2. Official Description

The official description of HCPCS code G9719 is “Patient is not ambulatory, bedridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair.” The short description for this code is “Pt not ambul/immob/wc.”

3. Procedure

  1. Assess the patient’s mobility and determine if they meet the criteria described in the code.
  2. Document the patient’s condition and level of mobility in the medical record.
  3. Assign HCPCS code G9719 to accurately represent the patient’s mobility status.

4. When to use HCPCS code G9719

HCPCS code G9719 should be used when documenting and billing for patients who meet the specific criteria outlined in the code. This includes patients who are not ambulatory, bedridden, immobile, confined to a chair, wheelchair-bound, dependent on a helper pushing a wheelchair, independent in a wheelchair, or require minimal help in a wheelchair.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9719, healthcare providers should ensure that the patient’s medical record clearly documents their mobility status and the need for assistance or aids for movement. This documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9719 was added to the Healthcare Common Procedure Coding System on January 01, 2017. 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

The coverage for HCPCS code G9719 is determined by the carrier judgment. Medicare and other insurance providers may have specific guidelines and criteria for coverage. It is important to review the individual payer’s policies and guidelines to determine if this code is payable.

8. Examples

Here are five examples of when HCPCS code G9719 should be billed:

  1. A patient who is confined to a wheelchair due to a spinal cord injury.
  2. An elderly patient who is unable to walk independently and requires a wheelchair for mobility.
  3. A patient recovering from a lower limb amputation who is not yet able to ambulate.
  4. A patient with a severe musculoskeletal condition that limits their ability to walk or stand.
  5. A patient with a neurological disorder that affects their mobility and requires the use of a wheelchair.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *