How To Use HCPCS Code G2177

HCPCS code G2177 describes episodes of acute bronchitis or bronchiolitis when the patient had a new or refill prescription of antibiotics within the 30 days prior to the episode date. This code is used to identify cases where antibiotics were prescribed for the treatment of acute bronchitis or bronchiolitis. In this article, we will explore the details of HCPCS code G2177, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G2177?

HCPCS code G2177 is a specific code used in medical coding to identify cases of acute bronchitis or bronchiolitis when the patient had a new or refill prescription of antibiotics within the 30 days prior to the episode date. This code helps healthcare providers and insurance companies track and categorize the treatment of acute bronchitis or bronchiolitis with antibiotics.

2. Official Description

The official description of HCPCS code G2177 is “Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date.” The short description for this code is “Bronch w rx antibx 30d.”

3. Procedure

1. During the patient encounter, the healthcare provider assesses the symptoms and medical history of the patient.
2. If the patient presents with symptoms of acute bronchitis or bronchiolitis, the provider confirms the diagnosis through physical examination and possibly additional diagnostic tests.
3. If the provider determines that the patient requires treatment with antibiotics, they prescribe a new or refill prescription.
4. The provider documents the prescription of antibiotics in the patient’s medical record, including the specific antibiotic prescribed and the date of prescription.
5. The provider also notes the episode date of acute bronchitis or bronchiolitis.
6. When submitting the medical claim, the provider includes HCPCS code G2177 to indicate that the patient had a new or refill prescription of antibiotics within the 30 days prior to the episode date.

4. When to use HCPCS code G2177

HCPCS code G2177 should be used in cases where the patient has been diagnosed with acute bronchitis or bronchiolitis and has received a new or refill prescription of antibiotics within the 30 days prior to the episode date. It is important to note that this code is specific to acute bronchitis or bronchiolitis and should not be used for other respiratory conditions or infections.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2177, healthcare providers need to ensure proper documentation of the following:

• Confirmation of the diagnosis of acute bronchitis or bronchiolitis
• Prescription of antibiotics within the 30 days prior to the episode date
• Details of the prescribed antibiotics, including the name and dosage
• Date of the episode of acute bronchitis or bronchiolitis

Providers should also follow the specific billing guidelines of their respective insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G2177 was added to the Healthcare Common Procedure Coding System on January 01, 2021. As of January 01, 2022, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G2177 may vary depending on the insurance carrier. Medicare and other insurers may have specific guidelines and policies regarding the reimbursement of services or supplies associated with this code. It is important for healthcare providers to verify coverage and reimbursement policies with the respective insurance companies.

8. Examples

Here are some examples of when HCPCS code G2177 should be billed:

1. Example 1: A patient presents with symptoms of acute bronchitis and has a new prescription of antibiotics within the 30 days prior to the episode date. The healthcare provider diagnoses the patient with acute bronchitis and includes HCPCS code G2177 in the medical claim.
2. Example 2: A patient with a history of bronchiolitis visits the healthcare provider with recurrent symptoms. The provider reviews the patient’s medical records and confirms that the patient had a refill prescription of antibiotics within the 30 days prior to the episode date. HCPCS code G2177 is included in the medical claim.
3. Example 3: A patient presents with symptoms of acute bronchitis and has a new prescription of antibiotics, but the prescription was not within the 30 days prior to the episode date. In this case, HCPCS code G2177 should not be billed.
4. Example 4: A patient is diagnosed with pneumonia and receives a prescription of antibiotics. Since HCPCS code G2177 is specific to acute bronchitis or bronchiolitis, it should not be billed in this case.
5. Example 5: A patient presents with symptoms of acute bronchitis and is prescribed antibiotics, but the antibiotics were not within the 30 days prior to the episode date. HCPCS code G2177 should not be billed in this scenario.