Showing codes G9536 (Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)) — G9578 (Documentation of signed opioid treatment agreement at least once during opioid therapy)

G9536 - Doc med reas adv brain image
Long description: Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
Code added date: 20160101.
Code effective date: 20190101.
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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G9537 - Img hd clin trial
Long description: Imaging needed as part of a clinical trial; or other clinician ordered the study
Code added date: 20160101.
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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G9538 - Adv brain image ordered
Long description: Advanced brain imaging (cta, ct, mra or mri) was ordered
Code added date: 20160101.
Code effective date: 20190101.
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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G9539 - Intent pot remv time placemt
Long description: Intent for potential removal at time of placement
Code added date: 20160101.
Code effective date: 20160101.
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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G9540 - Pt alive 3 mos post proc
Long description: Patient alive 3 months post procedure
Code added date: 20160101.
Code effective date: 20160101.
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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G9541 - Filter rem 3 mon plmt
Long description: Filter removed within 3 months of placement
Code added date: 20160101.
Code effective date: 20180101.
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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G9542 - Doc reass appr remo filt 3ms
Long description: Documented re-assessment for the appropriateness of filter removal within 3 months of placement
Code added date: 20160101.
Code effective date: 20160101.
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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G9543 - Doc 2x re-assess filt remov
Long description: Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
Code added date: 20160101.
Code effective date: 20160101.
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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G9544 - No filt remov w/in 3mos plcm
Long description: Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
Code added date: 20160101.
Code effective date: 20160101.
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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G9547 - Cys ren les or adren
Long description: Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols
Code added date: 20160101.
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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G9548 - No f/u rec image study
Long description: Final reports for imaging studies stating no follow-up imaging is recommended
Code added date: 20160101.
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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G9549 - Doc med rsn for f/u imag
Long description: Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))
Code added date: 20160101.
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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G9550 - Imag rec
Long description: Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up
Code added date: 20160101.
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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G9551 - Imag no les
Long description: Final reports for imaging studies without an incidentally found lesion noted
Code added date: 20160101.
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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G9552 - Inc thyr node <1.0 in rpt
Long description: Incidental thyroid nodule < 1.0 cm noted in report
Code added date: 20160101.
Code effective date: 20160101.
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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G9553 - Prior thyroid dise dx
Long description: Prior thyroid disease diagnosis
Code added date: 20160101.
Code effective date: 20160101.
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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G9554 - Ct/cta/mri/a chst foll rec
Long description: Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended
Code added date: 20160101.
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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G9555 - Doc med rsn for follup image
Long description: Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))
Code added date: 20160101.
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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G9556 - Ct/cta/mri/a no follup imag
Long description: Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging not recommended
Code added date: 20160101.
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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G9557 - Ct/cta/mri/a no thyr <1.0cm
Long description: Final reports for ct, cta, mri or mra studies of the chest or neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found
Code added date: 20160101.
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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G9558 - Tx beta-lactam abx therapy
Long description: Patient treated with a beta-lactam antibiotic as definitive therapy
Code added date: 20160101.
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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G9559 - Doc med reas no abx therapy
Long description: Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)
Code added date: 20160101.
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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G9560 - No beta-lactam abx ther, rng
Long description: Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given
Code added date: 20160101.
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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G9561 - Presc opiates >6 wks
Long description: Patients prescribed opiates for longer than six weeks
Code added date: 20160101.
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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G9562 - Foll-up eval q3mo opiod tx
Long description: Patients who had a follow-up evaluation conducted at least every three months during opioid therapy
Code added date: 20160101.
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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G9563 - No f/u eval q3mo opiod tx
Long description: Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy
Code added date: 20160101.
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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G9572 - Phq-scr >9 doc in 12m time
Long description: Index date phq-score greater than 9 documented during the twelve month denominator identification period
Code added date: 20160101.
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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G9573 - Adl pt md or dys rem 6 mon
Long description: Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five
Code added date: 20160101.
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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G9574 - Adl pt md dys no rem 6 mon
Long description: Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five
Code added date: 20160101.
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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G9577 - Presc opiates >6 wks
Long description: Patients prescribed opiates for longer than six weeks
Code added date: 20160101.
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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G9578 - Doc opioid tx 1x during ther
Long description: Documentation of signed opioid treatment agreement at least once during opioid therapy
Code added date: 20160101.
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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