How To Use HCPCS Code G9739

HCPCS code G9739 describes a specific situation where a patient is unable to complete the general orthopedic functional status (FS) prom at the initial evaluation and/or discharge. This inability may be due to various factors such as blindness, illiteracy, severe mental incapacity, or language incompatibility. It is important to note that this code is only applicable when an adequate proxy is not available to assist the patient.

1. What is HCPCS G9739?

HCPCS code G9739 is used to identify cases where a patient is unable to complete the general orthopedic functional status (FS) prom at the initial evaluation and/or discharge. This code is specifically used when the patient’s inability to complete the FS prom is attributed to factors such as blindness, illiteracy, severe mental incapacity, or language incompatibility. It is important to note that an adequate proxy is not available to assist the patient in these situations.

2. Official Description

The official description of HCPCS code G9739 is as follows: “Patient unable to complete the general orthopedic 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 for this code is “Pt unbl cmplt go fs prom.”

3. Procedure

  1. The healthcare provider should assess the patient’s ability to complete the general orthopedic FS prom at the initial evaluation and/or discharge.
  2. If the patient is unable to complete the FS prom due to blindness, illiteracy, severe mental incapacity, or language incompatibility, the provider should document this information.
  3. An adequate proxy should be determined as unavailable to assist the patient in completing the FS prom.
  4. The provider should use HCPCS code G9739 to indicate the patient’s inability to complete the FS prom in the medical coding and billing process.

4. When to use HCPCS code G9739

HCPCS code G9739 should be used in cases where a patient is unable to complete the general orthopedic FS prom at the initial evaluation and/or discharge. This code is specifically applicable when the patient’s inability to complete the FS prom is due to factors such as blindness, illiteracy, severe mental incapacity, or language incompatibility. It is important to note that an adequate proxy is not available to assist the patient in these situations.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9739, healthcare providers should ensure proper documentation of the patient’s inability to complete the general orthopedic FS prom. This documentation should include the specific reason for the patient’s inability, such as blindness, illiteracy, severe mental incapacity, or language incompatibility. Additionally, it should be clearly stated that an adequate proxy is not available to assist the patient. Proper documentation is crucial for accurate medical coding and billing.

6. Historical Information and Code Maintenance

HCPCS code G9739 was added to the Healthcare Common Procedure Coding System on January 01, 2017. It has an effective date of January 01, 2021. As of December 31, 2020, this code has been terminated. The termination of this code indicates that it is no longer in use for medical coding and billing purposes. It is important for medical coders to stay updated on code maintenance actions to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code G9739 is determined by the carrier’s judgment. 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 may be bundled or not covered by Medicare. The multiple pricing indicator code is 9, which means that the value for this code is not established. It is important for healthcare providers to verify coverage and pricing with Medicare or other insurance providers.

8. Examples

Here are some examples of scenarios where HCPCS code G9739 may be used:

  1. A patient with severe mental incapacity is unable to complete the general orthopedic FS prom at the initial evaluation.
  2. A patient who is blind cannot complete the general orthopedic FS prom due to their visual impairment.
  3. An illiterate patient is unable to complete the general orthopedic FS prom at the time of discharge.
  4. A patient with language incompatibility struggles to understand and complete the general orthopedic FS prom.
  5. In all of the above cases, an adequate proxy is not available to assist the patient in completing the FS prom.

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