How To Use HCPCS Code G8918

HCPCS code G8918 describes a specific situation where a patient undergoes a surgical procedure without a preoperative order for intravenous (IV) antibiotic surgical site infection (SSI) prophylaxis. This code is used to identify and bill for the provision of IV antibiotic prophylaxis in cases where there was no preoperative order for it.

1. What is HCPCS G8918?

HCPCS code G8918 is a specific code used in medical coding to identify and bill for the provision of IV antibiotic surgical site infection (SSI) prophylaxis in cases where there was no preoperative order for it. It is important to note that this code is only applicable in situations where the patient did not receive a preoperative order for IV antibiotic prophylaxis.

2. Official Description

The official description of HCPCS code G8918 is “Patient without preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis.” The short description for this code is “Pt w/o preop order IV ab pro.”

3. Procedure

1. The healthcare provider assesses the patient’s medical history and surgical procedure to determine if IV antibiotic prophylaxis is necessary.
2. If the provider determines that IV antibiotic prophylaxis is required, they administer the appropriate antibiotics intravenously.
3. The provider documents the administration of IV antibiotic prophylaxis in the patient’s medical record.

4. When to use HCPCS code G8918

HCPCS code G8918 should be used when a patient undergoes a surgical procedure without a preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis. It is important to ensure that there was no preoperative order for IV antibiotic prophylaxis before using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8918, healthcare providers need to document the lack of a preoperative order for IV antibiotic prophylaxis and provide supporting documentation in the patient’s medical record. This documentation should clearly indicate that the patient did not receive a preoperative order for IV antibiotic prophylaxis and justify the need for administering it during the surgical procedure.

6. Historical Information and Code Maintenance

HCPCS code G8918 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

Medicare and other insurance coverage for HCPCS code G8918 may vary. It is important to check with the specific insurance provider to determine if this code is payable and what the coverage guidelines are. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G8918 should be billed:

1. A patient undergoes a surgical procedure without a preoperative order for IV antibiotic prophylaxis, and the healthcare provider administers IV antibiotics during the procedure to prevent surgical site infection.
2. A patient with a known allergy to a specific antibiotic undergoes a surgical procedure without a preoperative order for IV antibiotic prophylaxis. The healthcare provider administers an alternative antibiotic intravenously to prevent surgical site infection.
3. A patient undergoes an emergency surgical procedure without a preoperative order for IV antibiotic prophylaxis. The healthcare provider administers IV antibiotics during the procedure to minimize the risk of surgical site infection.
4. A patient undergoes a minor surgical procedure without a preoperative order for IV antibiotic prophylaxis. The healthcare provider administers a single dose of IV antibiotics before the procedure to reduce the risk of surgical site infection.
5. A patient undergoes a major surgical procedure without a preoperative order for IV antibiotic prophylaxis. The healthcare provider administers a course of IV antibiotics before, during, and after the procedure to prevent surgical site infection.