How To Use HCPCS Code G9903

HCPCS code G9903 describes the screening of a patient for tobacco use and the identification of the patient as a tobacco non-user. This code is used to indicate that the healthcare provider has conducted a thorough assessment to determine whether the patient uses tobacco products and has determined that the patient does not use tobacco.

1. What is HCPCS G9903?

HCPCS code G9903 is a specific code used in medical coding to identify the screening of a patient for tobacco use and the determination that the patient is a tobacco non-user. It is important for healthcare providers to accurately document this information to ensure proper billing and reimbursement.

2. Official Description

The official description of HCPCS code G9903 is “Patient screened for tobacco use and identified as a tobacco non-user.” The short description is “Pt scrn tbco id as non user.”

3. Procedure

1. The healthcare provider initiates the screening process by asking the patient about their tobacco use history.
2. The provider may use a standardized questionnaire or interview the patient directly to gather information about their tobacco use habits.
3. If the patient reports using tobacco products, the provider may offer counseling or resources to help the patient quit.
4. If the patient reports not using tobacco products, the provider documents this information and identifies the patient as a tobacco non-user.
5. The provider may also provide education or resources to reinforce the benefits of not using tobacco.

4. When to use HCPCS code G9903

HCPCS code G9903 should be used when a healthcare provider has conducted a screening for tobacco use and has determined that the patient is a tobacco non-user. This code is not applicable if the patient is identified as a tobacco user or if the screening for tobacco use has not been performed.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9903, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the screening process, including the method used and the patient’s response.
• Documentation of the determination that the patient is a tobacco non-user.
• Any additional counseling or resources provided to the patient, if applicable.

6. Historical Information and Code Maintenance

HCPCS code G9903 was added to the Healthcare Common Procedure Coding System on January 01, 2018. As of the effective date, 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

HCPCS code G9903 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means that the value for this code is not established or not applicable as HCPCS is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9903 should be billed:

1. A patient visits their primary care physician for an annual wellness exam. As part of the exam, the physician screens the patient for tobacco use and determines that the patient is a tobacco non-user.
2. A dentist performs a routine dental check-up on a patient. During the visit, the dentist asks the patient about their tobacco use and confirms that the patient does not use tobacco products.
3. A pulmonologist sees a patient with respiratory symptoms. As part of the evaluation, the pulmonologist screens the patient for tobacco use and finds that the patient is a tobacco non-user.
4. A nurse practitioner provides smoking cessation counseling to a patient who is interested in quitting smoking. The nurse practitioner documents the patient’s tobacco non-user status using HCPCS code G9903.
5. A psychiatrist evaluates a patient with a history of substance abuse. As part of the assessment, the psychiatrist screens the patient for tobacco use and determines that the patient is a tobacco non-user.