How To Use HCPCS Code G9190

HCPCS code G9190 describes the documentation of medical reason(s) for not prescribing beta-blocker therapy. This code is used to indicate that there is a specific medical reason, such as an allergy, intolerance, or other medical reasons, for not prescribing beta-blocker therapy to a patient.

1. What is HCPCS G9190?

HCPCS code G9190 is used to identify the documentation of medical reason(s) for not prescribing beta-blocker therapy. It is important for healthcare providers to accurately document the specific medical reason(s) why beta-blocker therapy is not being prescribed to a patient.

2. Official Description

The official description of HCPCS code G9190 is “Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons).” The short description is “Medical reason for no beta.”

3. Procedure

  1. When documenting the medical reason(s) for not prescribing beta-blocker therapy, healthcare providers should clearly state the specific reason(s) why beta-blocker therapy is not being prescribed.
  2. Examples of medical reasons may include allergies to beta-blockers, intolerance to beta-blocker therapy, or other medical conditions that contraindicate the use of beta-blockers.
  3. It is important for healthcare providers to provide detailed and accurate documentation to support the medical reason(s) for not prescribing beta-blocker therapy.

4. When to use HCPCS code G9190

HCPCS code G9190 should be used when there is a documented medical reason(s) for not prescribing beta-blocker therapy to a patient. This code should only be used when there is a specific medical reason(s) that contraindicates the use of beta-blockers.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9190, healthcare providers should ensure that the documentation clearly supports the medical reason(s) for not prescribing beta-blocker therapy. The documentation should include the specific medical reason(s) and any relevant clinical information.

6. Historical information and Code Maintenance

HCPCS code G9190 was added to the Healthcare Common Procedure Coding System on January 01, 2014. 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 G9190 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This code is typically bundled with other services and is not separately reimbursed.

8. Examples

Here are five examples of when HCPCS code G9190 should be billed:

  1. A patient has a documented allergy to beta-blockers, and the healthcare provider determines that it is not safe to prescribe beta-blocker therapy.
  2. A patient has a history of intolerance to beta-blocker therapy, and the healthcare provider decides not to prescribe beta-blockers due to potential adverse reactions.
  3. A patient has a medical condition that contraindicates the use of beta-blockers, such as severe bradycardia, and the healthcare provider determines that beta-blocker therapy is not appropriate.
  4. A patient has a documented medical reason(s) for not tolerating beta-blocker therapy, such as significant side effects or complications from previous use.
  5. A patient has a medical condition that requires alternative treatment options, and the healthcare provider determines that beta-blocker therapy is not the most appropriate course of treatment.

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