Showing codes G9977 (Dilated macular exam was not performed, reason not otherwise specified) — GH (Diagnostic mammogram converted from screening mammogram on same day)

G9977 - Dil mac exam no perf rsn nos
Long description: Dilated macular exam was not performed, reason not otherwise specified
Code added date: 20180101.
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).
HTML    PDF

G9978 - Remote e/m new pt 10mins
Long description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9979 - Remote e/m new pt 20mins
Long description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9980 - Remote e/m new pt 30 mins
Long description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9981 - Remote e/m new pt 45mins
Long description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9982 - Remote e/m new pt 60mins
Long description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9983 - Remote e/m est. pt 10mins
Long description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9984 - Remote e/m est. pt 15mins
Long description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9985 - Remote e/m est. pt 25mins
Long description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9986 - Remote e/m est. pt 40mins
Long description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9987 - Bpci advanced in home visit
Long description: Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code
Code added date: 20181001.
Code effective date: 20181001.
Pricing Indicator Code(s): 13 ; (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

G9988 - Pall serv during meas
Long description: Palliative care services provided to patient any time during the measurement period
Code added date: 20220101.
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

G9989 - Med rsn no pneum vax
Long description: Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., adverse reaction to vaccine)
Code added date: 20220101.
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).
HTML    PDF

G9990 - No pneum vax admin 19+
Long description: Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
Code added date: 20220101.
Code effective date: 20240101.
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

G9991 - Pneum vax admin 19+
Long description: Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
Code added date: 20220101.
Code effective date: 20240101.
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

G9992 - Pall serv during meas
Long description: Palliative care services used by patient any time during the measurement period
Code added date: 20220101.
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

G9993 - Pall serv during meas
Long description: Patient was provided palliative care services any time during the measurement period
Code added date: 20220101.
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).
HTML    PDF

G9994 - Pall serv during meas
Long description: Patient is using palliative care services any time during the measurement period
Code added date: 20220101.
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

G9995 - Pall serv during meas
Long description: Patients who use palliative care services any time during the measurement period
Code added date: 20220101.
Code effective date: 20240101.
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

G9996 - Doc pt pal or hospice
Long description: Documentation stating the patient has received or is currently receiving palliative or hospice care
Code added date: 20220101.
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

G9997 - Doc pt preg dur msrmt pd
Long description: Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
Code added date: 20220101.
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

G9998 - Doc med rsn <3 colon
Long description: Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])
Code added date: 20220101.
Code effective date: 20240101.
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

G9999 - Doc sys rsn <3 colon
Long description: Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, previous colonoscopy report was incomplete)
Code added date: 20220101.
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

GA - Liability waiver ind case
Long description: Waiver of liability statement issued as required by payer policy, individual case
Code added date: 19950101.
Code effective date: 20110101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

GB - Claim resubmitted
Long description: Claim being re-submitted for payment because it is no longer covered under a global payment demonstration
Code added date: 20020101.
Code effective date: 20020101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

GC - Resident/teaching phys serv
Long description: This service has been performed in part by a resident under the direction of a teaching physician
Code added date: 19970101.
Code effective date: 20010101.
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

GD - Unit of service > mue value
Long description: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services
Code added date: 20080101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

GE - Resident prim care exception
Long description: This service has been performed by a resident without the presence of a teaching physician under the primary care exception
Code added date: 19970101.
Code effective date: 19970101.
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

GF - Nonphysician serv c a hosp
Long description: Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
Code added date: 20030401.
Code effective date: 20030401.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

GG - Payment screen mam + diagmam
Long description: Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day
Code added date: 20020101.
Code effective date: 20020101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

GH - Diag mammo to screening mamo
Long description: Diagnostic mammogram converted from screening mammogram on same day
Code added date: 19981001.
Code effective date: 19981001.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF