How To Use HCPCS Code G9732

HCPCS code G9732 describes a situation where a patient refuses to participate in a specific medical procedure or treatment. This code is used to indicate that the patient has declined to undergo the recommended intervention, whether it be a diagnostic test, therapy, or any other medical intervention. It is important for medical coders to understand the proper usage and documentation requirements for this code to ensure accurate billing and reimbursement.

1. What is HCPCS G9732?

HCPCS code G9732 is specifically assigned to indicate when a patient refuses to participate in a recommended medical procedure or treatment. It serves as a documentation tool for healthcare providers to record the patient’s decision to decline the intervention. This code is essential for accurate medical coding and billing purposes.

2. Official Description

The official description for HCPCS code G9732 is “Patient refused to participate.” The short description for this code is “Refused to participate.” These descriptions accurately reflect the meaning and purpose of this code.

3. Procedure

1. When a patient refuses to participate in a recommended medical procedure or treatment, the healthcare provider should document this refusal in the patient’s medical record.
2. The provider should clearly state the specific procedure or treatment that the patient declined.
3. It is important to include the date and time of the patient’s refusal to participate.
4. Any discussions or conversations with the patient regarding their decision should also be documented.
5. Ensure that the documentation is clear and concise, providing enough information to support the use of HCPCS code G9732.

4. When to use HCPCS code G9732

HCPCS code G9732 should be used when a patient refuses to participate in a recommended medical procedure or treatment. It is important to note that this code is only applicable when the patient actively declines the intervention. If the patient is unable to participate due to medical reasons or other circumstances beyond their control, a different code should be used to accurately reflect the situation.

5. Billing Guidelines and Documentation Requirements

When billing for services associated with HCPCS code G9732, healthcare providers should ensure that the following documentation requirements are met:

• Clear documentation of the patient’s refusal to participate in the recommended procedure or treatment.
• Inclusion of the specific procedure or treatment that the patient declined.
• Date and time of the patient’s refusal.
• Any relevant discussions or conversations with the patient regarding their decision.

6. Historical Information and Code Maintenance

HCPCS code G9732 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

HCPCS code G9732 is typically covered by insurance, including Medicare. However, it is important to check with individual payers to determine their specific coverage policies and guidelines. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the service is either not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which signifies that the value for this code is not established.

8. Examples

Here are five examples of scenarios where HCPCS code G9732 should be billed:

1. A patient refuses to undergo a recommended surgical procedure due to personal reasons.
2. A patient declines to participate in a clinical trial for a new medication.
3. A patient refuses to undergo a diagnostic test, such as an MRI or CT scan.
4. A patient declines to receive a specific therapy, such as physical therapy or occupational therapy.
5. A patient refuses to participate in a counseling session recommended by their healthcare provider.