How To Use HCPCS Code G9017

HCPCS code G9017 describes the oral administration of amantadine hydrochloride, specifically in a dosage of 100 mg per unit. This code is used for a specific purpose, which is to identify the use of amantadine hydrochloride in a Medicare-approved demonstration project. It is important for medical coders to understand the details and guidelines surrounding this code to ensure accurate billing and reimbursement.

1. What is HCPCS G9017?

HCPCS code G9017 is a specific code used to identify the oral administration of amantadine hydrochloride in a dosage of 100 mg per unit. It is important to note that this code is specifically used for the purpose of a Medicare-approved demonstration project. The code itself does not provide any information about the medical condition being treated or the specific circumstances of its use. It is solely used to identify the administration of amantadine hydrochloride in the specified dosage for the purposes of the demonstration project.

2. Official Description

The official description of HCPCS code G9017 is “Amantadine hydrochloride, oral, per 100 mg (for use in a Medicare-approved demonstration project).” This description clearly indicates that the code is used to identify the oral administration of amantadine hydrochloride in a dosage of 100 mg per unit specifically for use in a Medicare-approved demonstration project.

3. Procedure

1. The provider should ensure that the patient meets the eligibility criteria for the Medicare-approved demonstration project.
2. The provider should determine the appropriate dosage of amantadine hydrochloride based on the patient’s condition and the specific requirements of the demonstration project.
3. The provider should administer the amantadine hydrochloride orally to the patient in the specified dosage of 100 mg per unit.
4. The provider should document the administration of amantadine hydrochloride, including the dosage, date, and any relevant patient information.

4. When to use HCPCS code G9017

HCPCS code G9017 should be used when the oral administration of amantadine hydrochloride in a dosage of 100 mg per unit is being performed as part of a Medicare-approved demonstration project. It is important to ensure that the patient meets the eligibility criteria for the project and that the administration of amantadine hydrochloride is in accordance with the project’s guidelines and requirements.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of amantadine hydrochloride using HCPCS code G9017, healthcare providers should ensure that the following documentation is included:

• Date of service
• Patient information
• Dosage of amantadine hydrochloride administered
• Documentation supporting the use of the code for a Medicare-approved demonstration project

Providers should follow the specific billing guidelines and requirements set forth by Medicare or other insurers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9017 was added to the Healthcare Common Procedure Coding System on December 01, 2004. It has a termination date of December 31, 2019. This means that the code is no longer actively used for billing purposes after the termination date. It is important for medical coders to be aware of the termination date and ensure that alternative codes are used for any services provided after that date.

7. Medicare and Insurance Coverage

HCPCS code G9017 falls under the coverage code C, which indicates that coverage is determined by carrier judgment. This means that Medicare or other insurers will make a determination on whether the specific use of amantadine hydrochloride in a Medicare-approved demonstration project is covered and reimbursable. The pricing indicator code for this code is 13, which indicates that the price is established by carriers based on individual determination and carrier discretion.

8. Examples

Here are some examples of when HCPCS code G9017 should be billed:

1. A patient participates in a Medicare-approved demonstration project that involves the oral administration of amantadine hydrochloride in a dosage of 100 mg per unit. The provider documents the administration and bills using HCPCS code G9017.
2. A patient does not meet the eligibility criteria for the Medicare-approved demonstration project but still requires the oral administration of amantadine hydrochloride in a dosage of 100 mg per unit. In this case, HCPCS code G9017 should not be billed, and an alternative code should be used.
3. A provider administers amantadine hydrochloride orally to a patient in a dosage of 50 mg per unit, which does not meet the specific requirements of the Medicare-approved demonstration project. In this case, HCPCS code G9017 should not be billed, and an alternative code should be used.