How To Use HCPCS Code G9918

HCPCS code G9918 describes a specific situation where functional status is not performed, and the reason for not performing it is not otherwise specified. This code is used to indicate that a healthcare provider did not assess the functional status of a patient and there is no specific reason provided for not performing the assessment.

1. What is HCPCS G9918?

HCPCS code G9918 is a specific code used in medical coding to identify the situation where functional status is not performed, and the reason for not performing it is not otherwise specified. This code is used to indicate that the healthcare provider did not assess the functional status of a patient and there is no specific reason provided for not performing the assessment.

2. Official Description

The official description of HCPCS code G9918 is “Functional status not performed, reason not otherwise specified.” The short description for this code is “No funct stat perf, rsn nos.”

3. Procedure

1. When using HCPCS code G9918, the healthcare provider should document that the functional status assessment was not performed.
2. The provider should also indicate that there is no specific reason provided for not performing the assessment.
3. It is important to accurately document the patient’s medical record to support the use of this code.

4. When to use HCPCS code G9918

HCPCS code G9918 should be used when the healthcare provider did not perform a functional status assessment on a patient, and there is no specific reason provided for not performing the assessment. This code is used to indicate the absence of a functional status assessment in the patient’s medical record.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9918, healthcare providers need to accurately document that the functional status assessment was not performed and there is no specific reason provided for not performing the assessment. The documentation should clearly support the use of this code and provide a clear explanation for the absence of the assessment.

6. Historical Information and Code Maintenance

HCPCS code G9918 was added to the Healthcare Common Procedure Coding System on January 01, 2018. Since its addition, 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 G9918 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 either not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which means that the value is not established or the code is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9918 should be billed:

1. A patient visits a healthcare provider for a routine check-up, but the functional status assessment is not performed, and there is no specific reason provided for not performing it.
2. A patient is admitted to a hospital for a surgical procedure, but the functional status assessment is not performed, and there is no specific reason provided for not performing it.
3. A patient is seen in an emergency room for a minor injury, but the functional status assessment is not performed, and there is no specific reason provided for not performing it.
4. A patient is receiving home healthcare services, but the functional status assessment is not performed, and there is no specific reason provided for not performing it.
5. A patient is undergoing physical therapy, but the functional status assessment is not performed, and there is no specific reason provided for not performing it.