How To Use HCPCS Code G9553

HCPCS code G9553 describes a prior thyroid disease diagnosis. This code is used to indicate that a patient has been previously diagnosed with a thyroid disease. In this article, we will explore the details of HCPCS code G9553, 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 G9553?

HCPCS code G9553 is used to identify a prior thyroid disease diagnosis. It indicates that the patient has a history of thyroid disease. This code is important for medical coders and healthcare providers to accurately document and bill for services related to the patient’s thyroid condition.

2. Official Description

The official description of HCPCS code G9553 is “Prior thyroid dise dx.” This short description indicates that the code is used to document a prior diagnosis of thyroid disease.

3. Procedure

1. Obtain the patient’s medical records and review the documentation to confirm the prior diagnosis of thyroid disease.
2. Ensure that the diagnosis is clearly documented and supported by appropriate clinical findings.
3. Assign HCPCS code G9553 to indicate the prior thyroid disease diagnosis.

4. When to use HCPCS code G9553

HCPCS code G9553 should be used when a patient has a documented prior diagnosis of thyroid disease. This code is not used for the initial diagnosis of thyroid disease, but rather to indicate that the patient has a history of thyroid disease.

5. Billing Guidelines and Documentation Requirements

When billing for services related to a patient with a prior thyroid disease diagnosis (HCPCS code G9553), healthcare providers should ensure that the following documentation requirements are met:

• Medical records should clearly indicate the prior diagnosis of thyroid disease.
• Clinical findings supporting the diagnosis should be documented.
• Any additional relevant information, such as treatment plans or medications, should be included in the medical records.

6. Historical Information and Code Maintenance

HCPCS code G9553 was added to the Healthcare Common Procedure Coding System on January 01, 2016. 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

Medicare and insurance coverage for HCPCS code G9553 may vary. It is important to check with the specific payer to determine if this code is payable and what the coverage guidelines are. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. The multiple pricing indicator code is 9, which indicates that the value is not established.

8. Examples

Here are five examples of when HCPCS code G9553 should be billed:

1. A patient presents for a routine check-up and has a documented history of thyroid disease.
2. A patient undergoes a thyroid ultrasound, and the medical records indicate a prior diagnosis of thyroid disease.
3. A patient is prescribed medication for thyroid disease, and the prior diagnosis is documented in the medical records.
4. A patient is referred to an endocrinologist for management of their thyroid disease, and the prior diagnosis is documented in the referral.
5. A patient undergoes a thyroid function test, and the medical records indicate a prior diagnosis of thyroid disease.