How To Use HCPCS Code G9384

HCPCS code G9384 describes the documentation of medical reasons for not receiving annual screening for HCV infection. This code is used to indicate that the patient has a valid medical reason for not undergoing the recommended screening, such as decompensated cirrhosis indicating advanced disease, hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, or other medical reasons.

1. What is HCPCS G9384?

HCPCS code G9384 is a specific code used in medical coding to identify the documentation of medical reasons for not receiving annual screening for HCV infection. It is important for medical coders to accurately assign this code to ensure proper reimbursement and to maintain accurate medical records.

2. Official Description

The official description of HCPCS code G9384 is “Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)”. The short description for this code is “Doc med rsn no hcv scrn”.

3. Procedure

1. When documenting medical reasons for not receiving annual screening for HCV infection, the healthcare provider should clearly state the specific medical condition or circumstances that prevent the patient from undergoing the screening.
2. The documentation should include details about the patient’s condition, such as decompensated cirrhosis indicating advanced disease (e.g., ascites, esophageal variceal bleeding, hepatic encephalopathy), hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, or other medical reasons.
3. It is important to provide sufficient information to support the medical necessity of not undergoing the recommended screening.

4. When to use HCPCS code G9384

HCPCS code G9384 should be used when the patient has a valid medical reason for not receiving annual screening for HCV infection. This code is applicable in cases where the patient’s medical condition or circumstances prevent them from undergoing the recommended screening. It is important to review the official description and short description of the code to ensure accurate usage.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9384, healthcare providers need to document the medical reasons for not receiving annual screening for HCV infection. The documentation should clearly state the specific medical condition or circumstances that prevent the patient from undergoing the screening. It is important to provide sufficient information to support the medical necessity of not undergoing the recommended screening.

6. Historical Information and Code Maintenance

HCPCS code G9384 was added to the Healthcare Common Procedure Coding System on January 01, 2015. As of January 01, 2018, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated on any changes or revisions to the code.

7. Medicare and Insurance Coverage

HCPCS code G9384 is covered by Medicare. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered by Medicare. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established. It is important to review the specific guidelines and policies of Medicare and other insurance providers for accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code G9384 should be billed:

1. A patient with decompensated cirrhosis indicating advanced disease, including ascites, esophageal variceal bleeding, and hepatic encephalopathy, who is not eligible for annual screening for HCV infection.
2. A patient diagnosed with hepatocellular carcinoma who is undergoing treatment and is not able to undergo annual screening for HCV infection.
3. A patient on the waitlist for an organ transplant who is not eligible for annual screening for HCV infection.
4. A patient with limited life expectancy who is not recommended to undergo annual screening for HCV infection.
5. A patient with other medical reasons, such as a contraindication to the screening procedure, who is not able to undergo annual screening for HCV infection.