How To Use HCPCS Code G9200

HCPCS code G9200 describes the situation where venous thromboembolism (VTE) prophylaxis was not administered on the day of or the day after hospital admission, and the reason for not administering the prophylaxis is not given. This code is used to indicate the absence of VTE prophylaxis and the lack of documentation regarding the reason for not administering it.

1. What is HCPCS G9200?

HCPCS code G9200 is a specific code used in medical coding to identify the situation where VTE prophylaxis was not administered on the day of or the day after hospital admission, and the reason for not administering it is not provided. It is important for medical coders to accurately assign this code when documenting the absence of VTE prophylaxis and the lack of information regarding the reason for not administering it.

2. Official Description

The official description of HCPCS code G9200 is “Venous thromboembolism (VTE) prophylaxis was not administered the day of or the day after hospital admission, reason not given.” The short description for this code is “No reason for no VTE.”

3. Procedure

1. When assigning HCPCS code G9200, the medical coder should review the patient’s medical records to determine if VTE prophylaxis was administered on the day of or the day after hospital admission.
2. If the documentation indicates that VTE prophylaxis was not administered, the coder should ensure that there is no documented reason for not administering it.
3. If there is no documented reason for not administering VTE prophylaxis, the medical coder can assign HCPCS code G9200 to accurately reflect this situation.

4. When to use HCPCS code G9200

HCPCS code G9200 should be used when the medical documentation indicates that VTE prophylaxis was not administered on the day of or the day after hospital admission, and there is no documented reason for not administering it. This code is used to capture the absence of VTE prophylaxis and the lack of information regarding the reason for not administering it.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9200, healthcare providers should ensure that the medical documentation clearly indicates the absence of VTE prophylaxis and the lack of documentation regarding the reason for not administering it. This information is crucial for accurate coding and billing.

6. Historical Information and Code Maintenance

HCPCS code G9200 was added to the Healthcare Common Procedure Coding System on January 1, 2014. It has a termination date of December 31, 2014. This code is no longer maintained, and there have been no updates or revisions since its termination.

7. Medicare and Insurance Coverage

HCPCS code G9200 is not separately priced by Medicare or other insurers. It falls under the pricing indicator code 00, which means it is not separately priced by Part B. This code is typically bundled or not covered by insurance, and reimbursement may be based on other services provided during the hospital admission.

8. Examples

Here are five examples of when HCPCS code G9200 should be billed:

1. A patient is admitted to the hospital for a surgical procedure but does not receive VTE prophylaxis on the day of or the day after admission, and there is no documented reason for not administering it.
2. A patient is admitted to the hospital with a medical condition that requires hospitalization, but VTE prophylaxis is not administered on the day of or the day after admission, and there is no documented reason for not administering it.
3. A patient is admitted to the hospital for observation, but VTE prophylaxis is not administered on the day of or the day after admission, and there is no documented reason for not administering it.
4. A patient is admitted to the hospital for a diagnostic procedure, but VTE prophylaxis is not administered on the day of or the day after admission, and there is no documented reason for not administering it.
5. A patient is admitted to the hospital for a minor surgical procedure, but VTE prophylaxis is not administered on the day of or the day after admission, and there is no documented reason for not administering it.