How To Use HCPCS Code G9020

HCPCS code G9020 describes the oral administration of rimantadine 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 rimantadine hydrochloride in a Medicare-approved demonstration project. In this article, we will delve into the details of HCPCS code G9020, 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 G9020?

HCPCS code G9020 is a specific code used to identify the oral administration of rimantadine hydrochloride in a dosage of 100 mg. It is important to note that this code is specifically used in the context of a Medicare-approved demonstration project. The purpose of this code is to track the usage and administration of rimantadine hydrochloride in a controlled setting for research or evaluation purposes.

2. Official Description

The official description of HCPCS code G9020 is “Rimantadine hydrochloride, oral, per 100 mg (for use in a Medicare-approved demonstration project)”. This description clearly indicates that this code is applicable only for the oral administration of rimantadine hydrochloride in a dosage of 100 mg, and specifically within the context of a Medicare-approved demonstration project.

3. Procedure

1. Obtain the necessary documentation and approval for participation in a Medicare-approved demonstration project.
2. Administer rimantadine hydrochloride orally to the patient.
3. Ensure that the dosage administered is 100 mg per unit.
4. Document the administration of rimantadine hydrochloride, including the date, time, dosage, and any relevant patient information.
5. Submit the appropriate billing and documentation for reimbursement.

4. When to use HCPCS code G9020

HCPCS code G9020 should be used when administering rimantadine hydrochloride orally in a dosage of 100 mg within the context of a Medicare-approved demonstration project. It is important to ensure that the project meets the eligibility criteria set forth by Medicare and that the administration of rimantadine hydrochloride aligns with the objectives of the demonstration project.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9020, healthcare providers need to ensure that they have the necessary documentation to support the administration of rimantadine hydrochloride. This documentation should include the date, time, dosage, patient information, and any other relevant details. Additionally, providers should follow the billing guidelines set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9020 was added to the Healthcare Common Procedure Coding System on December 01, 2004. It has a pricing indicator code of 13, which indicates that the price for this code is established by carriers. The code has a type of service code of 1, which signifies that it is related to medical care. It is important to note that HCPCS code G9020 was terminated on December 31, 2019, meaning that it is no longer actively used for billing purposes.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9020 may vary. It is important to consult the specific guidelines and policies set forth by Medicare or other insurance carriers to determine the coverage and reimbursement for the oral administration of rimantadine hydrochloride within the context of a Medicare-approved demonstration project. The pricing indicator code for this code is 13, indicating that the price is established by carriers.

8. Examples

Here are five examples of when HCPCS code G9020 should be billed:

1. A healthcare provider administers rimantadine hydrochloride orally in a dosage of 100 mg to a patient participating in a Medicare-approved demonstration project.
2. A research facility conducts a study on the effectiveness of rimantadine hydrochloride in a specific patient population within the context of a Medicare-approved demonstration project.
3. A healthcare organization evaluates the impact of rimantadine hydrochloride on patient outcomes as part of a Medicare-approved demonstration project.
4. A physician prescribes rimantadine hydrochloride in a dosage of 100 mg for a patient enrolled in a Medicare-approved demonstration project.
5. A healthcare provider documents the administration of rimantadine hydrochloride in a dosage of 100 mg to a patient participating in a Medicare-approved demonstration project.