New HCPCS code G0505:
Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, by the physician or other qualified healthcare professional in office or other outpatient setting or home or domiciliary or rest home.
This code has 10 required elements. Report an E&M if all 10 are not done.
- Cognition-focused evaluation including a pertinent history and examination.
- Medical decision making of moderate or high complexity (defined by the E&M guidelines).
- Functional assessment including decision-making capacity.
- Use of standardized instruments to stage dementia.
- Medication reconciliation and review for high-risk medications, if applicable.
- Evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized instrument(s).
- Evaluation of safety including motor vehicle operation, if applicable.
- Identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks.
- Advance care planning and addressing palliative care needs, if applicable and consistent with beneficiary preference.
- Creation of a care plan, including initial plans to address any neuropsychiatric symptoms and referral to community resources as needed; care plan shared with the patient and/or caregiver with initial education and support.
Separately reportable:
- CCM (99487, 99489, 99490)
- TCM (99495,99496)
- Behavioral Health Integration (G0502, G0503, G0504, G0507)
Not Billable on the same day
- 90785
- 90791
- 90792
- 96103
- 96120
- 96127
- 99201-99215
- 99324-99337
- 99341-99350
- 99366-99368
- 99497
- 99498
- 99374
- G0181, G0182
- G0506
We should get a CPT code in 2018 and this HCPCS code will be retired.