How To Use HCPCS Code G9729

HCPCS code G9729 describes a specific situation where a patient is unable to complete the Lower Extremity Physical Performance (LEPF) Prom at the initial evaluation and/or discharge due to various reasons such as blindness, illiteracy, severe mental incapacity, or language incompatibility, and an adequate proxy is not available. This code is used to indicate the inability of the patient to complete the LEPF Prom and the reasons behind it.

1. What is HCPCS G9729?

HCPCS code G9729 is a specific code used in medical coding to identify the situation where a patient is unable to complete the LEPF Prom at the initial evaluation and/or discharge. The LEPF Prom is a physical performance test that assesses the lower extremity function of a patient. This code is used to indicate the inability of the patient to complete the test due to reasons such as blindness, illiteracy, severe mental incapacity, or language incompatibility, and when an adequate proxy is not available.

2. Official Description

The official description of HCPCS code G9729 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 unbl cmplt lepf prom.”

3. Procedure

1. The healthcare provider should assess the patient’s ability to complete the LEPF Prom at 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.
3. An adequate proxy should not be available for the patient to complete the LEPF Prom.
4. The provider should use HCPCS code G9729 to indicate the patient’s inability to complete the test.

4. When to use HCPCS code G9729

HCPCS code G9729 should be used when a patient is unable to complete the LEPF Prom at the initial evaluation and/or discharge due to reasons such as blindness, illiteracy, severe mental incapacity, or language incompatibility. It is important to note that an adequate proxy should not be available for the patient to complete the test. This code should only be used in the specific context described in the official description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9729, healthcare providers should ensure that the documentation supports the patient’s inability to complete the LEPF Prom due to the specified reasons. The medical record should clearly indicate the patient’s condition or circumstances that prevent them from completing the test. It is important to provide detailed and accurate documentation to support the use of this code.

6. Historical Information and Code Maintenance

HCPCS code G9729 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. This code has a pricing indicator code of 00, which means it 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.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G9729 may vary. It is important to check with the specific payer for their coverage policies and guidelines. The pricing indicator code of 00 indicates that the service is not separately priced by Part B, which means it may not be covered or reimbursed separately. Providers should follow the guidelines and requirements of the payer when submitting claims for this code.

8. Examples

Here are some examples of when HCPCS code G9729 should be billed:

1. A patient with severe mental incapacity is unable to understand and complete the LEPF Prom at the initial evaluation.
2. A patient who is blind cannot perform the LEPF Prom due to the visual nature of the test.
3. An illiterate patient is unable to complete the LEPF Prom as it involves reading and following instructions.
4. A patient with language incompatibility cannot understand the instructions and requirements of the LEPF Prom.
5. When an adequate proxy is not available to assist the patient in completing the LEPF Prom.