How To Use HCPCS Code G8917

HCPCS code G8917 describes a specific situation where a patient has a preoperative order for intravenous (IV) antibiotic surgical site infection (SSI) prophylaxis, but the antibiotic was not initiated on time. This code is used to identify and document this particular scenario in medical coding and billing.

1. What is HCPCS G8917?

HCPCS code G8917 is a specific code used in medical coding to describe a patient who has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but the antibiotic was not initiated on time. This code helps healthcare providers and insurance companies accurately document and track instances where the administration of IV antibiotics for SSI prophylaxis was delayed.

2. Official Description

The official description of HCPCS code G8917 is “Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic not initiated on time.” The short description for this code is “Pt w IV ab not given on time.”

3. Procedure

1. The healthcare provider receives a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis.
2. The provider determines the appropriate IV antibiotic based on the patient’s medical history, allergies, and the specific surgical procedure.
3. The provider prepares the IV antibiotic according to the manufacturer’s instructions.
4. The provider administers the IV antibiotic to the patient before the surgical procedure to prevent surgical site infections.

4. When to use HCPCS code G8917

HCPCS code G8917 should be used when a patient has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but the antibiotic was not initiated on time. This code is applicable in situations where there was a delay in administering the IV antibiotic as prescribed by the healthcare provider.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8917, healthcare providers need to document the preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis and the reason for the delay in initiating the antibiotic. The documentation should clearly indicate the date and time of the order, the scheduled time for administration, and any factors that contributed to the delay.

6. Historical Information and Code Maintenance

HCPCS code G8917 was added to the Healthcare Common Procedure Coding System on April 01, 2012. Since its addition, 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

HCPCS code G8917 is covered by Medicare and other insurance providers. However, it is important to check with individual insurance plans for specific coverage and reimbursement policies. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the value for this code is not established.

8. Examples

Here are five examples of when HCPCS code G8917 should be billed:

1. A patient has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but due to a delay in pharmacy processing, the antibiotic is not initiated on time.
2. A patient with a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis experiences a medical emergency that requires immediate attention, resulting in a delay in administering the antibiotic.
3. A patient has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but the surgical procedure is delayed, causing a delay in initiating the antibiotic.
4. A patient has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but the healthcare provider encounters difficulties in accessing the necessary supplies, leading to a delay in administering the antibiotic.
5. A patient has a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, but the healthcare provider fails to initiate the antibiotic on time due to an oversight or miscommunication.