How To Use HCPCS Code G9386

HCPCS code G9386 describes the screening for HCV infection that has not been received within the 12-month reporting period, with no reason given. This code is used to identify the specific service provided and is important for medical coders to accurately document and bill for this screening procedure.

1. What is HCPCS G9386?

HCPCS code G9386 is used to indicate that a screening for HCV infection has not been received within the 12-month reporting period, and no reason has been provided for the lack of screening. This code helps healthcare providers track and monitor the screening status of patients for HCV infection.

2. Official Description

The official description of HCPCS code G9386 is “Screening for HCV infection not received within the 12-month reporting period, reason not given.” The short description for this code is “Scrn hcv infec not recd.”

3. Procedure

1. When a patient presents for a screening for HCV infection, the healthcare provider should assess the patient’s medical history and risk factors for HCV.
2. The provider should obtain the necessary consent from the patient for the screening procedure.
3. The screening for HCV infection can be performed using various methods, such as blood tests or rapid diagnostic tests.
4. The provider should follow the appropriate testing protocols and guidelines for conducting the screening.
5. Once the screening is completed, the results should be documented in the patient’s medical record.
6. If the screening for HCV infection has not been received within the 12-month reporting period and no reason has been given, HCPCS code G9386 should be used to indicate this.

4. When to use HCPCS code G9386

HCPCS code G9386 should be used when a patient has not received the screening for HCV infection within the 12-month reporting period, and no reason has been provided for the lack of screening. This code helps healthcare providers track and monitor the screening status of patients for HCV infection.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9386, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s medical history and risk factors for HCV infection
• Consent for the screening procedure
• Documentation of the screening procedure performed
• Documentation of the screening results

Providers should also follow the billing guidelines set forth by Medicare or other insurance carriers to ensure proper reimbursement for the screening procedure.

6. Historical Information and Code Maintenance

HCPCS code G9386 was added to the Healthcare Common Procedure Coding System on January 01, 2015. 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 G9386 is covered by Medicare and other insurance carriers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service is bundled or not covered by Part B. The multiple pricing indicator code is 9, which means that the value for this code is not established.

8. Examples

Here are five examples of when HCPCS code G9386 should be billed:

1. A patient presents for a routine check-up, and the healthcare provider determines that the patient is due for a screening for HCV infection. However, the patient declines the screening without providing a reason. HCPCS code G9386 should be used to indicate that the screening was not received.
2. A patient with a history of intravenous drug use visits a healthcare provider for an unrelated issue. The provider recommends a screening for HCV infection, but the patient refuses without providing a reason. HCPCS code G9386 should be used to indicate that the screening was not received.
3. A patient with a known risk factor for HCV infection visits a healthcare provider for a routine follow-up. The provider recommends a screening for HCV infection, but the patient states that they have already received the screening at another facility. In this case, HCPCS code G9386 should not be used, as the screening has been received.
4. A patient presents for a screening for HCV infection, but the healthcare provider determines that the patient had received the screening within the 12-month reporting period. HCPCS code G9386 should not be used in this case, as the screening has been received.
5. A patient presents for a screening for HCV infection, but the healthcare provider determines that the patient had received the screening within the 12-month reporting period. However, the patient provides a valid reason for the repeat screening. In this case, HCPCS code G9386 should not be used, as the screening has been received and a reason has been provided.