Showing codes G9399 (Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment) — G9429 (Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons))
G9399 - Doc disc tx choices
Long description: Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9400 - Doc reas no disc tx opt
Long description: Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9401 - No disc tx choices
Long description: No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9402 - Recd f/u w/in 30d disch
Long description: Patient received follow-up within 30 days after discharge
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9403 - Doc reas no 30 day f/u
Long description: Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9404 - No 30 day f/u
Long description: Patient did not receive follow-up within 30 days after discharge
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9405 - Recd f/u w/in 7d dc
Long description: Patient received follow-up within 7 days after discharge
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9406 - Doc reas no 7d f/u
Long description: Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9407 - No 7d f/u
Long description: Patient did not receive follow-up within 7 days after discharge
Code added date: 20150101.
Code effective date: 20250101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9408 - Card tamp w/in 30d
Long description: Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9409 - No card tamp e/in 30d
Long description: Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9410 - Admit w/in 180d req remov
Long description: Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9411 - No admit w/in 180d req remov
Long description: Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9412 - Admit w/in 180d req surg rev
Long description: Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9413 - No admit req surg rev
Long description: Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9414 - 1dose menig vac btwn 11 & 13
Long description: Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays
Code added date: 20150101.
Code effective date: 20200101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9415 - No 1dose meni vac btwn 11&13
Long description: Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays
Code added date: 20150101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9416 - Pt 1 tdap betw 10-13 yrs
Long description: Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
Code added date: 20150101.
Code effective date: 20170101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9417 - Pt not 1 tdap betw 10-13 yrs
Long description: Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
Code added date: 20150101.
Code effective date: 20170101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9418 - Lungcx bx rpt docs class
Long description: Primary non-small cell lung cancer lung biopsy and cytology specimen report documents classification into specific histologic type following iaslc guidance or classified as nsclc-nos with an explanation
Code added date: 20150101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9419 - Med reas not incl histo type
Long description: Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g. specimen insufficient or non-diagnostic, specimen does not contain cancer, or other documented medical reasons)
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9420 - Spec site no lung
Long description: Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9421 - Lung cx bx rpt no doc class
Long description: Primary non-small cell lung cancer lung biopsy and cytology specimen report does not document classification into specific histologic type or histologic type does not follow iaslc guidance or is classified as nsclc-nos but without an explanation
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9422 - Rpt doc class histo type
Long description: Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma and not nsclc-nos)
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9423 - Med reas rpt no histo type
Long description: Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9424 - Site no lung or lung cx
Long description: Specimen site other than anatomic location of lung, or classified as nsclc-nos
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9425 - Spec rpt no doc class histo
Long description: Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma)
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9426 - Impr med time edarr pain med
Long description: Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9427 - No impro med time pain med
Long description: Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients
Code added date: 20150101.
Code effective date: 20150101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9428 - Patho rpt incl pt ctg
Long description: Pathology report includes the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9429 - Doc med rsn no pt cat
Long description: Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons)
Code added date: 20150101.
Code effective date: 20220101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML
PDF