How To Use HCPCS Code G9727

HCPCS code G9727 describes a specific scenario where a patient is unable to complete the lepf prom (Lower Extremity Physical Performance Test) at the initial evaluation and/or discharge due to various reasons such as blindness, illiteracy, severe mental incapacity, or language incompatibility. This code is used when an adequate proxy is not available to complete the test on behalf of the patient.

1. What is HCPCS G9727?

HCPCS code G9727 is a unique alphanumeric code that is used in medical coding to identify a specific scenario where a patient is unable to complete the lepf prom at the initial evaluation and/or discharge due to certain limitations. This code is important for accurately documenting and billing for the services provided in such situations.

2. Official Description

The official description of HCPCS code G9727 is “Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available.” The short description of this code is “Pt unable cmplt lepf prom.”

3. Procedure

  1. The healthcare provider should assess the patient’s ability to complete the lepf prom during the initial evaluation or discharge.
  2. If the patient is unable to complete the test due to blindness, illiteracy, severe mental incapacity, or language incompatibility, the provider should document this information in the medical record.
  3. An adequate proxy should be considered, but if one is not available, the provider should indicate this in the documentation.
  4. The use of HCPCS code G9727 should be supported by thorough documentation of the patient’s limitations and the absence of an adequate proxy.

4. When to use HCPCS code G9727

HCPCS code G9727 should be used when a patient is unable to complete the lepf prom at the initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity, or language incompatibility. It is important to note that an adequate proxy should not be available in order to use this code.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9727, healthcare providers should ensure that the documentation clearly supports the patient’s inability to complete the lepf prom and the absence of an adequate proxy. The medical record should include detailed information about the patient’s limitations and the reasons why an adequate proxy is not available.

6. Historical Information and Code Maintenance

HCPCS code G9727 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of January 01, 2021, 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

HCPCS code G9727 is covered by Medicare and other insurance providers. However, it is important to verify coverage and reimbursement policies with the specific payer. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are some examples of scenarios where HCPCS code G9727 should be billed:

  1. A patient with severe mental incapacity is unable to complete the lepf prom during the initial evaluation, and there is no adequate proxy available.
  2. A patient who is blind cannot complete the lepf prom due to the inability to visually perceive the test instructions, and there is no adequate proxy present.
  3. An illiterate patient is unable to complete the lepf prom as they cannot read the instructions, and there is no adequate proxy to assist them.
  4. A patient with language incompatibility is unable to understand the test instructions and cannot complete the lepf prom, and there is no adequate proxy who can communicate effectively with the patient.
  5. A patient with multiple limitations, such as severe mental incapacity and blindness, is unable to complete the lepf prom, and there is no adequate proxy available to assist.

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