How To Use HCPCS Code G9725

HCPCS code G9725 describes patients who use hospice services at any time during the measurement period. This code is used to identify and track patients who receive hospice care, which is a specialized form of medical care provided to individuals who are terminally ill and have a life expectancy of six months or less.

1. What is HCPCS G9725?

HCPCS code G9725 is a specific code used in medical coding to identify patients who utilize hospice services during the measurement period. It is important to accurately assign this code to ensure proper documentation and billing for patients receiving hospice care.

2. Official Description

The official description of HCPCS code G9725 is “Patients who use hospice services any time during the measurement period.” The short description for this code is “Pt w/hosp anytime msmt per.”

3. Procedure

  1. Identify patients who have utilized hospice services during the measurement period.
  2. Ensure accurate documentation of the dates and duration of hospice care.
  3. Assign HCPCS code G9725 to indicate the use of hospice services.

4. When to use HCPCS code G9725

HCPCS code G9725 should be used when a patient has received hospice services at any time during the measurement period. This code is applicable to all patients who have utilized hospice care, regardless of the specific medical condition or treatment received.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9725, healthcare providers should ensure the following documentation requirements are met:

  • Accurate documentation of the dates and duration of hospice care.
  • Documentation of the specific hospice services provided.
  • Supporting medical records that demonstrate the medical necessity of hospice care.

6. Historical Information and Code Maintenance

HCPCS code G9725 was added to the Healthcare Common Procedure Coding System on January 1, 2017. It is important to note that this code will be terminated on December 31, 2023. The termination of this code indicates that it will no longer be valid for use in medical coding and billing after this date.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may provide coverage for hospice services identified by HCPCS code G9725. 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, indicating that the value for this code is not established.

8. Examples

Here are five examples of when HCPCS code G9725 should be billed:

  1. A patient with a terminal illness receives hospice care for three months during the measurement period.
  2. An elderly individual with a life expectancy of less than six months enters a hospice program and receives care until their passing.
  3. A patient with a progressive disease chooses to receive hospice services to manage their symptoms and improve their quality of life.
  4. A terminally ill child receives hospice care at home, with a team of healthcare professionals providing support to the child and their family.
  5. An individual with a terminal illness transitions from curative treatment to hospice care to focus on comfort and pain management.

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