How To Use HCPCS Code G9379
HCPCS code G9379 describes a specific situation where a patient did not achieve flat retinas six months post surgery. This code is used to indicate that the desired outcome of the surgery, which is to have flat retinas, was not achieved within the specified timeframe. In this article, we will explore the details of HCPCS code G9379, 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 G9379?
HCPCS code G9379 is a specific code used in medical coding to identify the situation where a patient did not achieve flat retinas six months after surgery. It is important to note that this code is only applicable in cases where the desired outcome of the surgery was not achieved within the specified timeframe.
2. Official Description
The official description of HCPCS code G9379 is “Patient did not achieve flat retinas six months post surgery.” This description clearly indicates the specific situation that this code represents.
3. Procedure
- The procedure associated with HCPCS code G9379 involves assessing the patient’s retinas six months after surgery.
- The healthcare provider will carefully examine the patient’s retinas to determine if they have achieved the desired flatness.
- If the retinas are not flat, the provider will document this information and assign the appropriate HCPCS code, which in this case is G9379.
4. When to use HCPCS code G9379
HCPCS code G9379 should be used when a patient’s retinas have not achieved the desired flatness within six months after surgery. It is important to note that this code is specific to the timeframe of six months and should not be used for other timeframes or situations.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code G9379, healthcare providers need to ensure that they have documented the patient’s retinal status accurately. This documentation should clearly indicate that the retinas did not achieve flatness within the specified timeframe of six months post-surgery. Additionally, providers should follow the standard billing guidelines and requirements set forth by the relevant insurance companies or Medicare.
6. Historical Information and Code Maintenance
HCPCS code G9379 was added to the Healthcare Common Procedure Coding System on January 01, 2015. It has a termination date of December 31, 2015. This code is no longer active and should not be used for billing purposes after the termination date. It is important for medical coders to stay updated on code maintenance actions to ensure accurate and compliant coding practices.
7. Medicare and Insurance Coverage
Medicare and insurance coverage for HCPCS code G9379 may vary. It is important for healthcare providers to check with the specific insurance companies or Medicare to determine if this code is payable. The pricing indicator code for G9379 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers.
8. Examples
Here are five examples of when HCPCS code G9379 should be billed:
- A patient undergoes retinal surgery, and six months later, it is determined that their retinas have not achieved the desired flatness.
- After retinal surgery, a patient’s retinas are assessed at the six-month mark, and it is documented that they have not achieved the desired flatness.
- A healthcare provider performs retinal surgery on a patient, and during the follow-up appointment six months later, it is determined that the retinas are still not flat.
- Following retinal surgery, the patient’s retinas are examined at the six-month mark, and it is noted that they have not achieved the desired flatness.
- A patient undergoes retinal surgery, and at the six-month follow-up appointment, it is determined that their retinas are still not flat.
