How To Use HCPCS Code G9733

HCPCS code G9733 describes a specific situation where a patient is unable to complete the low back functional status (FS) prom 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 assist the patient in completing the FS prom. It is important for medical coders to understand the meaning and usage of this code to accurately document and bill for the services provided.

1. What is HCPCS G9733?

HCPCS code G9733 is a unique alphanumeric code that is part of the Healthcare Common Procedure Coding System (HCPCS). It is used to identify a specific scenario where a patient is unable to complete the low back FS prom due to certain limitations and an adequate proxy is not available. This code helps healthcare providers and insurers accurately document and track the services provided to patients in this particular situation.

2. Official Description

The official description of HCPCS code G9733 is “Patient unable to complete the low back FS 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 lb fs prom.”

3. Procedure

  1. During the initial evaluation or discharge process, the healthcare provider assesses the patient’s ability to complete the low back FS prom.
  2. If the patient is unable to complete the FS prom due to blindness, illiteracy, severe mental incapacity, or language incompatibility, the provider determines if an adequate proxy is available.
  3. If an adequate proxy is available, the proxy assists the patient in completing the FS prom.
  4. If an adequate proxy is not available, the provider documents the patient’s inability to complete the FS prom and uses HCPCS code G9733 to indicate this scenario.

4. When to use HCPCS code G9733

HCPCS code G9733 should be used when a patient is unable to complete the low back FS prom at the initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity, or language incompatibility, and an adequate proxy is not available. It is important to accurately document this scenario to ensure proper coding and billing for the services provided.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9733, healthcare providers need to document the specific reason why the patient is unable to complete the low back FS prom and the absence of an adequate proxy. This documentation should be clear, concise, and support the medical necessity of using this code. When billing for the service, providers should follow the standard billing guidelines and include the appropriate HCPCS code on the claim form.

6. Historical Information and Code Maintenance

HCPCS code G9733 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of January 01, 2020, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The pricing indicator code for HCPCS code G9733 is 00, which means the service is not separately priced by Part B. This code is not applicable for separate reimbursement and is typically bundled or not covered by Medicare or other insurers.

7. Medicare and Insurance Coverage

HCPCS code G9733 is typically not separately reimbursed by Medicare or other insurers. The pricing indicator code 00 indicates that the service is not separately priced by Part B and is often bundled or not covered. It is important for healthcare providers to verify the coverage and reimbursement policies of specific payers to ensure accurate billing and reimbursement for the services provided.

8. Examples

Here are some examples of scenarios where HCPCS code G9733 may be used:

  1. A patient with severe mental incapacity is unable to complete the low back FS prom during the initial evaluation, and no adequate proxy is available.
  2. A blind patient cannot complete the low back FS prom due to their visual impairment, and there is no adequate proxy to assist them.
  3. An illiterate patient is unable to complete the low back FS prom, and there is no adequate proxy present to help them.
  4. A patient with language incompatibility cannot understand the instructions for the low back FS prom, and there is no adequate proxy who can communicate with them effectively.
  5. A patient with multiple limitations, such as severe mental incapacity and blindness, is unable to complete the low back FS prom, and there is no adequate proxy available to assist them.

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