How To Use HCPCS Code G9742

HCPCS code G9742 describes the assessment of psychiatric symptoms. This code is used to identify the specific service provided by healthcare professionals to evaluate and assess the mental health condition of a patient. In this article, we will delve into the details of HCPCS code G9742, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G9742?

HCPCS code G9742 is used to identify the assessment of psychiatric symptoms. It is specifically designed to capture the evaluation and assessment of mental health conditions by healthcare professionals. This code is essential for accurately documenting and billing for the services provided in relation to psychiatric symptom assessment.

2. Official Description

The official description of HCPCS code G9742 is “Psychiatric symptoms assessed.” This concise description accurately represents the purpose and scope of this code.

3. Procedure

  1. The healthcare provider begins by gathering relevant information about the patient’s psychiatric symptoms, including their duration, severity, and impact on daily functioning.
  2. Next, a comprehensive assessment is conducted to evaluate the patient’s mental health condition. This may involve conducting interviews, administering standardized assessments, and reviewing medical records.
  3. The provider analyzes the collected information and formulates a diagnosis or treatment plan based on their professional judgment and expertise.
  4. Finally, the results of the psychiatric symptom assessment are documented in the patient’s medical record for future reference and communication with other healthcare providers.

4. When to use HCPCS code G9742

HCPCS code G9742 should be used when healthcare professionals perform a comprehensive assessment of psychiatric symptoms. This code is applicable in various clinical settings, including outpatient clinics, psychiatric hospitals, and mental health facilities. It is important to note that this code is not intended for routine mental health screenings or brief assessments, but rather for more in-depth evaluations of psychiatric symptoms.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9742, healthcare providers need to ensure that the following documentation requirements are met:

  • Clearly document the assessment of psychiatric symptoms, including the specific symptoms evaluated and the methods used for assessment.
  • Include the findings of the assessment, such as the diagnosis or treatment plan formulated based on the assessment results.
  • Ensure that the medical record supports the medical necessity of the psychiatric symptom assessment.

6. Historical Information and Code Maintenance

HCPCS code G9742 was added to the Healthcare Common Procedure Coding System on January 1, 2017. It has an effective date of January 1, 2020. As of December 31, 2019, this code has been terminated and is no longer valid for use. The termination of this code indicates that it is no longer recognized as a separate and distinct service for billing purposes.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may have specific coverage policies for HCPCS code G9742. It is important to consult the respective payer’s guidelines to determine if this code is payable and the reimbursement rates associated with it. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the value for this code is not established.

8. Examples

Here are five examples of scenarios where HCPCS code G9742 should be billed:

  1. A psychiatrist conducts a comprehensive assessment of a patient’s psychiatric symptoms, including interviews, psychological testing, and review of medical records, to formulate a diagnosis and treatment plan.
  2. A clinical psychologist evaluates a child’s behavioral and emotional symptoms, using standardized assessments and parent interviews, to determine an appropriate intervention plan.
  3. A psychiatric nurse practitioner assesses a patient’s response to medication for a mental health condition, conducting a thorough evaluation of symptoms and side effects.
  4. A licensed clinical social worker performs a comprehensive assessment of a patient’s trauma-related symptoms, utilizing evidence-based assessments and clinical interviews, to develop a personalized treatment approach.
  5. A psychiatric hospital conducts a comprehensive psychiatric symptom assessment for a patient admitted with acute mental health concerns, involving a multidisciplinary team of healthcare professionals.

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