How To Use HCPCS Code G9720

HCPCS code G9720 describes hospice services for patients that occurred at any time during the measurement period. This code is used to identify and bill for the provision of hospice care to patients who require end-of-life care and support. In this article, we will explore the details of HCPCS code G9720, 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 G9720?

HCPCS code G9720 is used to identify hospice services provided to patients at any time during the measurement period. It is important to note that this code specifically pertains to hospice care and should not be used for other types of medical services or procedures.

2. Official Description

The official description of HCPCS code G9720 is “Hospice services for patient occurred any time during the measurement period.” The short description for this code is “Hospice anytime msmt per.” These descriptions accurately convey the purpose and scope of this code.

3. Procedure

  1. When providing hospice services to a patient, ensure that the care is delivered in accordance with the established guidelines and regulations for hospice care.
  2. Document all relevant information regarding the patient’s hospice care, including the dates of service, the specific services provided, and any other pertinent details.
  3. Submit the appropriate claim or billing form, including the HCPCS code G9720, along with the necessary supporting documentation.
  4. Ensure that the claim or billing form accurately reflects the services provided and the corresponding dates of service.

4. When to use HCPCS code G9720

HCPCS code G9720 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 care and should not be used for other types of medical services or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for hospice services using HCPCS code G9720, healthcare providers need to ensure that they have the necessary documentation to support the claim. This may include the patient’s medical records, the hospice care plan, and any other relevant documentation.

6. Historical Information and Code Maintenance

HCPCS code G9720 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 providers may cover hospice services billed under HCPCS code G9720. However, it is important to check with the specific payer to determine their coverage policies and requirements. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. The multiple pricing indicator code is 9, which means that it is not applicable as HCPCS is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9720 should be billed:

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

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