How To Use HCPCS Code G2195

HCPCS code G2195 describes the specific clinical indication for imaging of the head: occipital headache in children. This code is used to identify and bill for services related to the evaluation and imaging of children who present with occipital headaches. In this article, we will explore the details of HCPCS code G2195, 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 G2195?

HCPCS code G2195 is a specific code used to identify and bill for imaging services related to the evaluation of occipital headaches in children. It is important to note that this code is only applicable for children with clinical indications for imaging of the head specifically related to occipital headaches.

2. Official Description

The official description of HCPCS code G2195 is “Patients with clinical indications for imaging of the head: occipital headache in children.” The short description is “Occip hdache child.”

3. Procedure

1. The provider begins by evaluating the child’s medical history and symptoms, paying particular attention to the occurrence and characteristics of occipital headaches.
2. If the provider determines that imaging of the head is necessary to further evaluate the occipital headaches, they will proceed with the appropriate imaging procedure.
3. The imaging procedure may involve techniques such as magnetic resonance imaging (MRI), computed tomography (CT), or other diagnostic imaging modalities.
4. The provider will interpret the results of the imaging study and use the findings to guide further diagnosis and treatment.

4. When to use HCPCS code G2195

HCPCS code G2195 should be used when a child presents with clinical indications for imaging of the head specifically related to occipital headaches. It is important to ensure that the child meets the criteria for this specific clinical indication before using this code for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G2195, healthcare providers should ensure that the medical documentation supports the clinical indications for imaging of the head due to occipital headaches in children. This documentation should include a detailed description of the patient’s symptoms, medical history, and the provider’s rationale for ordering the imaging study. Additionally, the provider should document the results of the imaging study and any subsequent diagnosis or treatment plans based on those results.

6. Historical Information and Code Maintenance

HCPCS code G2195 was added to the Healthcare Common Procedure Coding System on January 01, 2021. As of its addition date, 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

Medicare and insurance coverage for HCPCS code G2195 may vary. It is important for healthcare providers to verify coverage with the specific payer before performing and billing for the services associated with this code. The pricing indicator code for HCPCS code G2195 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G2195 should be billed:

1. A 10-year-old child presents with recurrent occipital headaches. The provider determines that imaging of the head is necessary to further evaluate the cause of the headaches.
2. A 7-year-old child experiences severe occipital headaches accompanied by other neurological symptoms. The provider orders imaging of the head to assess for any underlying abnormalities.
3. A 12-year-old child has been experiencing persistent occipital headaches that have not responded to conservative treatment. The provider decides to perform imaging of the head to investigate potential causes.
4. A 9-year-old child presents with occipital headaches following a head injury. The provider orders imaging of the head to rule out any traumatic brain injury.
5. A 6-year-old child has a history of occipital headaches associated with visual disturbances. The provider recommends imaging of the head to assess for any structural abnormalities.