How To Use HCPCS Code G9376
HCPCS code G9376 describes the continued attachment of the retina at the 6-month follow-up visit following only one surgery. This code is used to indicate that the patient’s retina remains attached after a specified period of time since the surgery. In this article, we will delve into the details of HCPCS code G9376, 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 G9376?
HCPCS code G9376 is used to identify the specific situation where the patient’s retina remains attached at the 6-month follow-up visit following only one surgery. This code is essential for accurately documenting and billing for the continued attachment of the retina after the surgical procedure.
2. Official Description
The official description of HCPCS code G9376 is “Patient continued to have the retina attached at the 6 months follow-up visit (+/- 1 month) following only one surgery.” The short description for this code is “Contd ret attach at 6mth f/u.”
3. Procedure
- The provider will schedule a follow-up visit with the patient approximately 6 months after the initial surgery.
- During the visit, the provider will thoroughly examine the patient’s eye to assess the status of the retina.
- If the retina is found to be attached, the provider will document this information in the patient’s medical record.
- The provider may use additional diagnostic tests or procedures to confirm the attachment of the retina.
- Once the assessment is complete, the provider will determine the appropriate course of action based on the findings.
4. When to use HCPCS code G9376
HCPCS code G9376 should be used when the patient’s retina remains attached at the 6-month follow-up visit following only one surgery. It is important to note that this code is specific to this particular scenario and should not be used for other situations involving retinal attachment or follow-up visits.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code G9376, healthcare providers must ensure that the following documentation requirements are met:
- Clearly indicate the 6-month follow-up visit in the patient’s medical record.
- Document the findings of the retinal examination, confirming the attachment of the retina.
- Include any additional diagnostic tests or procedures performed during the visit.
Providers should also follow the billing guidelines set forth by the relevant insurance carriers to ensure accurate and timely reimbursement.
6. Historical Information and Code Maintenance
HCPCS code G9376 was added to the Healthcare Common Procedure Coding System on January 1, 2015. It has an effective date of January 1, 2016. As of December 31, 2015, this code was terminated. The termination indicates that this specific code is no longer in use and should not be billed for services rendered after the termination date.
7. Medicare and Insurance Coverage
Medicare and insurance coverage for HCPCS code G9376 may vary. It is important to consult the specific guidelines and policies of the respective payers 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, indicating that the value for pricing this code is not established.
8. Examples
Here are five examples of when HCPCS code G9376 should be billed:
- A patient undergoes retinal surgery, and at the 6-month follow-up visit, the retina is found to be attached.
- Following a single retinal surgery, the patient’s retina remains attached at the 6-month follow-up visit.
- A provider performs retinal surgery, and at the 6-month follow-up, the patient’s retina is still attached.
- After a successful retinal surgery, the patient’s retina remains attached at the 6-month follow-up visit.
- At the 6-month follow-up visit, the provider confirms that the patient’s retina is attached following a single surgery.
