How To Use HCPCS Code G9351

HCPCS code G9351 describes the use of more than one CT scan of the paranasal sinuses ordered or received within 90 days after diagnosis. This code is used to identify and bill for this specific medical procedure. In this article, we will explore the details of HCPCS code G9351, 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 G9351?

HCPCS code G9351 is used to identify the specific medical procedure of more than one CT scan of the paranasal sinuses ordered or received within 90 days after diagnosis. It is important to use this code accurately to ensure proper billing and documentation of the procedure.

2. Official Description

The official description of HCPCS code G9351 is “More than one CT scan of the paranasal sinuses ordered or received within 90 days after diagnosis.” The short description for this code is “Doc >1 sinus CT w 90d dx.”

3. Procedure

1. The provider will order or receive a diagnosis of a condition related to the paranasal sinuses.
2. Based on the diagnosis, the provider determines that more than one CT scan of the paranasal sinuses is necessary within a 90-day period.
3. The provider schedules and performs the CT scans as required.
4. The results of the CT scans are reviewed and used for further diagnosis and treatment planning.

4. When to use HCPCS code G9351

HCPCS code G9351 should be used when a patient requires more than one CT scan of the paranasal sinuses within 90 days after diagnosis. It is important to ensure that the diagnosis and medical necessity for multiple CT scans are clearly documented in the patient’s medical records.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9351, healthcare providers need to document the following:

• The diagnosis that necessitates the multiple CT scans of the paranasal sinuses.
• The date of each CT scan performed.
• The medical necessity for ordering or receiving more than one CT scan within a 90-day period.
• The results of the CT scans and any subsequent treatment or follow-up plans.

6. Historical Information and Code Maintenance

HCPCS code G9351 was added to the Healthcare Common Procedure Coding System on January 01, 2014. Since its addition, 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 G9351 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. It is important to check with individual insurance providers for specific coverage and reimbursement guidelines.

8. Examples

Here are five examples of when HCPCS code G9351 should be billed:

1. A patient is diagnosed with chronic sinusitis and requires multiple CT scans of the paranasal sinuses within a 90-day period to monitor the progression of the condition.
2. A patient with a history of nasal polyps undergoes multiple CT scans of the paranasal sinuses within 90 days to assess the effectiveness of a new treatment.
3. A patient presents with recurrent sinus infections and undergoes multiple CT scans of the paranasal sinuses within 90 days to identify any underlying anatomical abnormalities.
4. A patient with a suspected sinus tumor undergoes multiple CT scans of the paranasal sinuses within 90 days to evaluate the size and extent of the tumor.
5. A patient with a history of trauma to the face undergoes multiple CT scans of the paranasal sinuses within 90 days to assess the extent of the injury and guide surgical intervention.