Summary & Overview
HCPCS G9380: End-of-Life Assistance or Plan Review
HCPCS Level II code G9380 documents when a patient is offered assistance with end-of-life issues or when an existing end-of-life plan is reviewed or updated. This code captures advance care planning and related counseling activities that clarify patient preferences, document directives, and support transitions to palliative or hospice care. Nationally, accurate use of G9380 supports quality measurement, care coordination, and alignment of services with patient values at the end of life.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and administrative purpose, expectations for typical settings of care, and what to consider when mapping G9380 to program reporting or quality measurement. The publication outlines common modifiers and payer considerations where available, notes where input data are missing, and summarizes implications for documentation and claims processing. The focus is national in scope and intended to inform clinical coders, compliance teams, and policy analysts about the role of G9380 in advance care planning workflows and quality programs.
Billing Code Overview
HCPCS Level II code G9380 indicates that a patient was offered assistance with end-of-life issues or an existing end-of-life plan was reviewed or updated during the measurement period. This code documents conversations and care planning related to end-of-life preferences, advanced care planning, or updates to an existing end-of-life directive.
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Service type: End-of-life counseling and advance care planning discussion
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Typical site of service: Ambulatory clinics, primary care offices, hospice programs, long-term care settings, and other outpatient or community-based care locations where advance care planning conversations occur
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult or geriatric patient with a serious, progressive, or life-limiting condition who meets with a clinician to discuss goals of care, advance directives, or to review and update an existing end-of-life plan during the measurement period. Example: an 82-year-old patient with advanced congestive heart failure and chronic kidney disease presents to a primary care or palliative care clinic for a routine follow-up. During a 30–45 minute visit the clinician reviews the patient’s existing advance directive, confirms current goals of care, discusses preferences for hospitalization, intubation, and hospice, documents surrogate decision-maker information, and updates the POLST or advance directive form in the medical record. The workflow typically includes pre-visit chart review, a focused conversation with the patient and/or family, documentation of the visit content and any completed forms, and electronic health record coding or billing using the appropriate HCPCS Level II code G9380. Typical sites of service are outpatient clinic, primary care office, palliative care clinic, home health visit, or inpatient consultation when the end-of-life plan is reviewed or updated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When substantially greater work is performed than typical for the visit due to extended end-of-life counseling. |