How To Use HCPCS Code G9779

HCPCS code G9779 describes patients who are breastfeeding at any time during the performance period. This code is used to identify and track the provision of healthcare services for breastfeeding individuals. In this article, we will explore the details of HCPCS code G9779, 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 G9779?

HCPCS code G9779 is a specific code used in medical coding to identify patients who are breastfeeding during the performance period. It is important to accurately document and report this information to ensure proper tracking and provision of healthcare services for breastfeeding individuals.

2. Official Description

The official description of HCPCS code G9779 is “Patients who are breastfeeding at any time during the performance period.” The short description for this code is “Pts breastfeeding.”

3. Procedure

1. During the performance period, healthcare providers should assess whether the patient is breastfeeding or has breastfed at any time.
2. If the patient is breastfeeding or has breastfed, the provider should document this information in the patient’s medical record.
3. When submitting claims or reporting healthcare services, the provider should use HCPCS code G9779 to indicate that the patient is breastfeeding.

4. When to use HCPCS code G9779

HCPCS code G9779 should be used when the patient is breastfeeding or has breastfed at any time during the performance period. It is important to accurately document this information to ensure appropriate healthcare services are provided to breastfeeding individuals.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9779, healthcare providers should ensure the following:

• Accurately document the patient’s breastfeeding status in the medical record.
• Include the HCPCS code G9779 on the claim form or when reporting healthcare services.
• Follow any specific billing guidelines or requirements set forth by the payer or insurance company.

6. Historical Information and Code Maintenance

HCPCS code G9779 was added to the Healthcare Common Procedure Coding System on January 01, 2017. The long description of the procedure or modifier code was changed, indicating a modification to the code’s description. The effective date of this change was January 01, 2024. No specific historical information or significant changes have been reported for this code.

7. Medicare and Insurance Coverage

HCPCS code G9779 is classified as a carrier judgment code, indicating that coverage and payment decisions are made by the insurance carrier based on their judgment. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service may be bundled or not covered by Medicare or other insurers. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS code G9779 is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9779 should be billed:

1. A patient visits their primary care physician for a routine check-up and informs the provider that they are currently breastfeeding. The provider documents this information and includes HCPCS code G9779 on the claim form.
2. A lactation consultant provides breastfeeding education and support to a new mother during a postpartum visit. The consultant includes HCPCS code G9779 on the claim form to indicate that the patient is breastfeeding.
3. A patient receives a breast pump rental from a durable medical equipment supplier. The supplier includes HCPCS code G9779 on the claim form to indicate that the patient is breastfeeding.
4. A breastfeeding individual undergoes a surgical procedure and informs the anesthesiologist of their breastfeeding status. The anesthesiologist includes HCPCS code G9779 on the claim form to indicate that the patient is breastfeeding.
5. A healthcare provider provides lactation counseling services to a patient who is experiencing difficulties with breastfeeding. The provider includes HCPCS code G9779 on the claim form to indicate that the patient is breastfeeding.