How To Use HCPCS Code G9758

HCPCS code G9758 describes a patient who is in hospice at any time during the measurement period. This code is used to identify and track patients who are receiving hospice care, which is a specialized type of care for individuals who are terminally ill and have a life expectancy of six months or less. Hospice care focuses on providing comfort and support to patients and their families, rather than attempting to cure the underlying illness.

1. What is HCPCS G9758?

HCPCS code G9758 is specifically used to indicate that a patient was in hospice at some point during the measurement period. It is important to accurately document and code this information to ensure proper tracking and reimbursement for the services provided to hospice patients.

2. Official Description

The official description of HCPCS code G9758 is “Patient in hospice at any time during the measurement period.” The short description for this code is “Pt in hos.”

3. Procedure

1. During the measurement period, the healthcare provider should assess whether the patient received hospice care at any point.
2. If the patient was in hospice, the provider should document the dates of hospice care and any relevant details about the services provided.
3. This information should be accurately coded using HCPCS code G9758.

4. When to use HCPCS code G9758

HCPCS code G9758 should be used when a patient has received hospice care at any time during the measurement period. It is important to note that this code is not specific to a particular type of hospice service or setting. It simply indicates that the patient was in hospice care, regardless of the specific circumstances.

5. Billing Guidelines and Documentation Requirements

When billing for services related to HCPCS code G9758, healthcare providers should ensure that the following documentation requirements are met:

• Accurate documentation of the dates when the patient received hospice care
• Details about the services provided during the hospice care period
• Supporting documentation, such as progress notes or discharge summaries, that demonstrate the need for hospice care

6. Historical Information and Code Maintenance

HCPCS code G9758 was added to the Healthcare Common Procedure Coding System on January 1, 2017. As of the effective date of January 1, 2018, 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

Medicare and other insurance providers may cover services related to HCPCS code G9758. However, it is important to check with the specific payer to determine coverage and reimbursement policies. 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 or other insurers.

8. Examples

Here are five examples of scenarios where HCPCS code G9758 should be billed:

1. A patient is admitted to a hospice facility for end-of-life care and remains in hospice care for the entire measurement period.
2. A patient receives hospice care at home for a portion of the measurement period before transitioning to a hospice facility.
3. A patient is discharged from a hospital and placed under hospice care for the remainder of the measurement period.
4. A patient is in hospice care for a short period during the measurement period before being discharged from hospice.
5. A patient receives intermittent hospice care at home throughout the measurement period.