2017 Coding Changes: Cognitive Impairment (New Service)

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.

  1. Cognition-focused evaluation including a pertinent history and examination.
  2. Medical decision making of moderate or high complexity (defined by the E&M guidelines).
  3. Functional assessment including decision-making capacity.
  4. Use of standardized instruments to stage dementia.
  5. Medication reconciliation and review for high-risk medications, if applicable.
  6. Evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized instrument(s).
  7. Evaluation of safety including motor vehicle operation, if applicable.
  8. Identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks.
  9. Advance care planning and addressing palliative care needs, if applicable and consistent with beneficiary preference.
  10. 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.

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