How To Use HCPCS Code G9887

HCPCS code G9887 describes behavioral counseling for diabetes prevention through distance learning. This code is used to identify the specific service provided and is essential for accurate medical coding and billing. In this article, we will explore the details of HCPCS code G9887, 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 G9887?

HCPCS code G9887 is a unique alphanumeric code that is used to identify a specific medical service or procedure. In the case of G9887, it represents behavioral counseling for diabetes prevention through distance learning. This code is essential for medical coders and billers to accurately document and report the services provided to patients.

2. Official Description

The official description of HCPCS code G9887 is “Behavioral counseling for diabetes prevention, distance learning, 60 minutes.” This description provides important details about the service, including the specific type of counseling (behavioral counseling), the purpose (diabetes prevention), the method of delivery (distance learning), and the duration (60 minutes).

3. Procedure

  1. The provider initiates the distance learning session with the patient.
  2. During the session, the provider engages in behavioral counseling techniques to educate the patient about diabetes prevention.
  3. The counseling session lasts for a duration of 60 minutes.
  4. The provider documents the details of the counseling session, including the topics discussed and any recommendations provided to the patient.

4. When to use HCPCS code G9887

HCPCS code G9887 should be used when a healthcare provider delivers behavioral counseling for diabetes prevention through distance learning. This code is specifically intended for patients who are at risk of developing diabetes and require counseling to modify their behaviors and reduce their risk. It is important to ensure that the counseling session meets the criteria outlined in the official description to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9887, healthcare providers need to document the following information:

  • Date of the counseling session
  • Duration of the session (60 minutes)
  • Details of the counseling provided
  • Topics discussed during the session
  • Any recommendations or action plans given to the patient

It is crucial to ensure that the documentation supports the medical necessity of the counseling session and demonstrates compliance with the official description of the code.

6. Historical Information and Code Maintenance

HCPCS code G9887 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of its addition, there have been no maintenance actions taken for this code. This indicates that there have been no updates, revisions, or terminations since its inclusion in the coding system.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9887 may vary. The pricing indicator code for G9887 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled with other services or not covered by Medicare. It is important to check with individual payers to determine their specific coverage policies for this code.

8. Examples

Here are five examples of scenarios where HCPCS code G9887 should be billed:

  1. A patient with prediabetes attends a 60-minute distance learning counseling session focused on diabetes prevention.
  2. A healthcare provider delivers behavioral counseling through distance learning to a patient who has been identified as at risk for developing diabetes.
  3. A patient with a family history of diabetes participates in a 60-minute distance learning counseling session to learn about preventive measures.
  4. A healthcare provider conducts a remote counseling session with a patient who has recently been diagnosed with prediabetes, providing guidance on lifestyle modifications.
  5. A patient attends a distance learning counseling session to receive education and support for diabetes prevention, with the session lasting for 60 minutes.

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