How To Use HCPCS Code G9253

HCPCS code G9253 describes the situation where adenoma(s) or other neoplasm are not detected during a screening colonoscopy. This code was terminated on December 31, 2014, and it falls under the category of “No neo detect scrn colo”. It is important for medical coders to understand the specific usage and guidelines for this code to ensure accurate billing and documentation.

1. What is HCPCS G9253?

HCPCS code G9253 is used to identify cases where adenoma(s) or other neoplasm are not detected during a screening colonoscopy. This code is specific to situations where no abnormal growths or tumors are found during the procedure. It is important to note that this code is no longer active and was terminated on December 31, 2014.

2. Official Description

The official description of HCPCS code G9253 is “Adenoma(s) or other neoplasm not detected during screening colonoscopy”. The short description for this code is “No neo detect scrn colo”. These descriptions accurately reflect the purpose and usage of this code.

3. Procedure

1. Prepare the patient for a screening colonoscopy according to standard medical protocols.
2. Perform the colonoscopy procedure, carefully examining the colon for any abnormal growths or tumors.
3. If no adenoma(s) or other neoplasm are detected during the screening colonoscopy, assign HCPCS code G9253 to indicate the absence of any abnormal findings.

4. When to use HCPCS code G9253

HCPCS code G9253 should be used in cases where a screening colonoscopy is performed, but no adenoma(s) or other neoplasm are detected. It is important to ensure that the procedure meets the criteria for a screening colonoscopy, as defined by the appropriate medical guidelines and payer policies. This code should not be used if any abnormal growths or tumors are found during the procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9253, healthcare providers should ensure that the documentation clearly indicates that no adenoma(s) or other neoplasm were detected during the screening colonoscopy. This information should be supported by the medical record, including any relevant findings or observations made during the procedure. It is important to follow the specific billing guidelines and requirements set forth by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9253 was added to the Healthcare Common Procedure Coding System on January 01, 2014. It had an effective date of January 01, 2015. This code was terminated on December 31, 2014, and no maintenance actions have been taken since then. The termination of this code indicates that it is no longer valid for billing purposes.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G9253 may vary. It is important to consult the specific guidelines and policies of the payer to determine if this code is payable. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. The multiple pricing indicator code is 9, which means that the code is not applicable for separate pricing by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9253 should be billed:

1. A patient undergoes a screening colonoscopy, and no adenoma(s) or other neoplasm are detected.
2. During a routine screening colonoscopy, the physician confirms the absence of any abnormal growths or tumors.
3. A patient with a family history of colon cancer undergoes a screening colonoscopy, and no adenoma(s) or other neoplasm are found.
4. Following a screening colonoscopy, the physician documents that no abnormal findings were observed.
5. A patient with a previous history of colon polyps undergoes a follow-up screening colonoscopy, and no adenoma(s) or other neoplasm are detected.