How To Use HCPCS Code G9299

HCPCS code G9299 describes patients who have not been evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to a procedure. This code indicates that the patient’s medical history, including any previous incidents of deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI), arrhythmia, and stroke, has not been assessed or documented. The code is used to indicate that the reason for not evaluating these risk factors is not provided.

1. What is HCPCS G9299?

HCPCS code G9299 is a specific code used in medical coding to identify patients who have not undergone an evaluation for venous thromboembolic and cardiovascular risk factors within 30 days prior to a procedure. This code is used to indicate that the patient’s medical history, including any previous incidents of DVT, PE, MI, arrhythmia, and stroke, has not been assessed or documented. It is important for medical coders to accurately assign this code to ensure proper documentation and billing.

2. Official Description

The official description of HCPCS code G9299 is “Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of DVT, PE, MI, arrhythmia and stroke, reason not given).” The short description of this code is “No eval risk vte card prior.”

3. Procedure

1. The procedure for HCPCS code G9299 involves assessing the patient’s medical history for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure.
2. If the patient has a history of DVT, PE, MI, arrhythmia, or stroke, the healthcare provider should document these conditions and evaluate the patient’s risk factors.
3. If the patient does not have a documented history of these conditions, the provider should indicate the reason for not evaluating the risk factors.

4. When to use HCPCS code G9299

HCPCS code G9299 should be used when a patient has not been evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to a procedure. This code is applicable when the patient’s medical history does not include any previous incidents of DVT, PE, MI, arrhythmia, or stroke, and the reason for not evaluating these risk factors is not provided.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9299, healthcare providers need to document the patient’s medical history and the reason for not evaluating the risk factors. This documentation is crucial for accurate billing and reimbursement. Providers should ensure that the medical records clearly indicate the absence of evaluation for venous thromboembolic and cardiovascular risk factors and the reason for not conducting the evaluation.

6. Historical Information and Code Maintenance

HCPCS code G9299 was added to the Healthcare Common Procedure Coding System on January 01, 2014. As of January 01, 2021, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code is classified under the HCPCS coverage code C, which signifies carrier judgment. The pricing indicator code for HCPCS code G9299 is 00, indicating that the service is not separately priced by Part B. The multiple pricing indicator code is 9, which means that the value for pricing indicator is not established or the code is not priced separately by Part B.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G9299 may vary. Providers should refer to the Medicare guidelines and the specific policies of other insurance companies to determine the coverage and reimbursement for this code. The pricing indicator code 00 indicates that the service is not separately priced by Part B, and the multiple pricing indicator code 9 suggests that the code is not priced separately or the value is not established.

8. Examples

Here are five examples of scenarios where HCPCS code G9299 should be billed:

1. A patient undergoes a surgical procedure, but their medical history does not include any previous incidents of DVT, PE, MI, arrhythmia, or stroke. The reason for not evaluating the risk factors is not provided.
2. A patient is scheduled for a cardiac catheterization procedure, but their medical history does not indicate any previous incidents of DVT, PE, MI, arrhythmia, or stroke. The reason for not evaluating the risk factors is not provided.
3. A patient is admitted for a non-cardiac surgical procedure, and their medical history does not show any previous incidents of DVT, PE, MI, arrhythmia, or stroke. The reason for not evaluating the risk factors is not provided.
4. A patient is undergoing a minor outpatient procedure, and their medical history does not include any previous incidents of DVT, PE, MI, arrhythmia, or stroke. The reason for not evaluating the risk factors is not provided.
5. A patient is scheduled for a diagnostic imaging procedure, but their medical history does not indicate any previous incidents of DVT, PE, MI, arrhythmia, or stroke. The reason for not evaluating the risk factors is not provided.