How To Use HCPCS Code G9993

HCPCS code G9993 describes the provision of palliative care services to a patient during the measurement period. Palliative care is a specialized form of medical care that focuses on providing relief from the symptoms and stress of a serious illness. It is aimed at improving the quality of life for both the patient and their family.

1. What is HCPCS G9993?

HCPCS code G9993 is used to identify the provision of palliative care services to a patient during the measurement period. This code is specifically used to indicate that the patient received palliative care services, which are designed to provide comfort and support to individuals with serious illnesses.

2. Official Description

The official description of HCPCS code G9993 is “Patient was provided palliative care services any time during the measurement period.” The short description is “Pall serv during meas.”

3. Procedure

1. Assessment: The healthcare provider evaluates the patient’s medical condition, symptoms, and overall well-being to determine the appropriate palliative care interventions.
2. Developing a care plan: Based on the assessment, the provider develops a personalized care plan that addresses the patient’s physical, emotional, and spiritual needs.
3. Managing symptoms: Palliative care focuses on managing symptoms such as pain, nausea, shortness of breath, and fatigue. The provider may prescribe medications, recommend therapies, or suggest lifestyle modifications to alleviate these symptoms.
4. Providing emotional support: Palliative care also involves providing emotional support to patients and their families. This may include counseling, support groups, and assistance with advance care planning.
5. Coordinating care: The provider collaborates with other healthcare professionals involved in the patient’s care to ensure seamless coordination and continuity of care.

4. When to use HCPCS code G9993

HCPCS code G9993 should be used when a patient receives palliative care services at any time during the measurement period. This code is applicable to patients with serious illnesses who require specialized care to manage their symptoms and improve their quality of life.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9993, healthcare providers need to document the following:

• Date of service: The specific date when the palliative care services were provided.
• Description of services: A detailed description of the palliative care services rendered, including any specific interventions or treatments.
• Duration of services: The length of time the patient received palliative care services during the measurement period.
• Provider information: The name, credentials, and contact information of the healthcare provider who delivered the palliative care services.

6. Historical information and Code Maintenance

HCPCS code G9993 was added to the Healthcare Common Procedure Coding System on January 01, 2022. It has an action code of N, indicating no maintenance for this code. The code’s action effective date is January 01, 2023. The pricing indicator code for HCPCS code G9993 is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered by Medicare.

7. Medicare and Insurance Coverage

HCPCS code G9993 is covered by Medicare, but it is not separately priced by Part B. This means that the service is bundled or not covered by Medicare. The multiple pricing indicator code for this code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9993 should be billed:

1. A patient with advanced cancer receives palliative care services to manage pain, nausea, and other symptoms.
2. An elderly patient with a chronic illness receives palliative care services to improve their quality of life and provide emotional support.
3. A terminally ill patient receives palliative care services to ensure their comfort and dignity during the end-of-life stage.
4. A patient with a progressive neurological condition receives palliative care services to address physical and emotional symptoms.
5. A patient with a life-limiting illness receives palliative care services to support their overall well-being and enhance their quality of life.