How To Use HCPCS Code G9721

HCPCS code G9721 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, or independent in a wheelchair with minimal help. This code is used to identify patients who require assistance or are unable to move independently due to their medical condition.

1. What is HCPCS G9721?

HCPCS code G9721 is a specific code used in medical coding to identify patients who are not ambulatory, bedridden, immobile, confined to a chair, wheelchair bound, dependent on a helper pushing the wheelchair, or independent in a wheelchair with minimal help. It provides important information about the patient’s mobility status and helps healthcare providers understand the level of assistance required for their care.

2. Official Description

The official description of HCPCS code G9721 is “Patient 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. When using HCPCS code G9721, the healthcare provider should assess the patient’s mobility status and determine if they meet the criteria specified in the code description.
  2. If the patient 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, the code G9721 should be assigned.
  3. It is important for the healthcare provider to accurately document the patient’s mobility status in the medical record to support the use of HCPCS code G9721.

4. When to use HCPCS code G9721

HCPCS code G9721 should be used when documenting the mobility status of a patient who meets the criteria described in the code. This code is applicable for patients who are not ambulatory, bedridden, immobile, confined to a chair, wheelchair bound, dependent on a helper pushing the wheelchair, independent in a wheelchair, or require minimal help in a wheelchair.

5. Billing Guidelines and Documentation Requirements

When billing for services or supplies associated with HCPCS code G9721, healthcare providers should ensure that the patient’s medical record clearly documents their mobility status. This documentation should support the use of the code and provide evidence of the patient’s need for assistance or limited mobility.

6. Historical Information and Code Maintenance

HCPCS code G9721 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

The coverage and pricing of HCPCS code G9721 may vary depending on the specific policies of Medicare and other insurance providers. It is important for healthcare providers to review the pricing indicator code and multiple pricing indicator code to determine how the service or supply associated with this code is priced by Medicare or other insurers.

8. Examples

Here are five examples of situations where HCPCS code G9721 should be billed:

  1. A patient who is unable to walk due to a recent leg injury and requires a wheelchair for mobility.
  2. An elderly patient who is bedridden and relies on a caregiver to push them in a wheelchair for transportation.
  3. A patient with a chronic illness that has left them immobile and dependent on a wheelchair for mobility.
  4. A patient who is confined to a chair due to a spinal cord injury and requires minimal assistance in a wheelchair.
  5. A patient with a physical disability who is independent in a wheelchair but may need occasional help for certain activities.

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