How To Use HCPCS Code G9996

HCPCS code G9996 describes the documentation stating that a patient has received or is currently receiving palliative or hospice care. This code is used to indicate that the patient is under the care of a healthcare provider who specializes in providing comfort and support to individuals with serious illnesses or at the end of life.

1. What is HCPCS G9996?

HCPCS code G9996 is a specific code used in medical coding to identify and document that a patient has received or is currently receiving palliative or hospice care. It is important for healthcare providers to accurately use this code to ensure proper reimbursement and to maintain accurate medical records.

2. Official Description

The official description of HCPCS code G9996 is “Documentation stating the patient has received or is currently receiving palliative or hospice care.” The short description for this code is “Doc pt pal or hospice.”

3. Procedure

1. When documenting the use of HCPCS code G9996, the healthcare provider should clearly state in the patient’s medical record that the patient has received or is currently receiving palliative or hospice care.
2. This documentation should include the start date of the palliative or hospice care, as well as any relevant details about the care being provided.
3. It is important for the healthcare provider to accurately document the use of this code to ensure proper billing and reimbursement.

4. When to use HCPCS code G9996

HCPCS code G9996 should be used when a patient has received or is currently receiving palliative or hospice care. This code is used to indicate that the patient is under the care of a healthcare provider who specializes in providing comfort and support to individuals with serious illnesses or at the end of life.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9996, healthcare providers should ensure that the necessary documentation is included in the patient’s medical record. This documentation should clearly state that the patient has received or is currently receiving palliative or hospice care.

6. Historical Information and Code Maintenance

HCPCS code G9996 was added to the Healthcare Common Procedure Coding System on January 01, 2022. As of this 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 G9996 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.

8. Examples

Here are some examples of when HCPCS code G9996 should be billed:

1. A patient with advanced cancer who is receiving palliative care to manage pain and improve quality of life.
2. A patient with a terminal illness who is receiving hospice care at home.
3. A patient with end-stage heart failure who is receiving palliative care to manage symptoms and provide emotional support.
4. A patient with a progressive neurological disease who is receiving hospice care in a specialized facility.
5. A patient with a life-limiting illness who is receiving palliative care to address physical, emotional, and spiritual needs.