How To Use HCPCS Code G9612

HCPCS code G9612 describes the photodocumentation of two or more cecal landmarks to establish a complete examination. This code is used to identify and bill for the specific procedure of capturing images of the cecal landmarks during a medical examination. In this article, we will explore the details of HCPCS code G9612, 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 G9612?

HCPCS code G9612 is a specific code used in medical coding to identify the photodocumentation of two or more cecal landmarks to establish a complete examination. It is important to note that this code is specific to the documentation of cecal landmarks and should not be used for other types of examinations or procedures.

2. Official Description

The official description of HCPCS code G9612 is “Photodocumentation of two or more cecal landmarks to establish a complete examination.” The short description for this code is “Phodoc 2 mr cec lndmk.”

3. Procedure

  1. The provider begins the procedure by preparing the patient for the examination.
  2. Using appropriate imaging equipment, the provider captures images of the cecal landmarks.
  3. The provider ensures that at least two cecal landmarks are clearly visible in the images.
  4. The images are then documented and stored for further analysis and reference.

4. When to use HCPCS code G9612

HCPCS code G9612 should be used when the provider performs the specific procedure of photodocumentation of two or more cecal landmarks to establish a complete examination. It is important to ensure that the documentation meets the requirements outlined in the official description of the code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9612, healthcare providers need to ensure that the documentation includes the following:

  • Clear and identifiable images of two or more cecal landmarks.
  • Date and time of the examination.
  • Patient information, including name and unique identifier.
  • Provider information, including name and credentials.

It is important to follow the specific billing guidelines and requirements set forth by the payer, as they may have additional documentation requirements.

6. Historical Information and Code Maintenance

HCPCS code G9612 was added to the Healthcare Common Procedure Coding System on January 01, 2016. It has an effective date of January 01, 2024, and was terminated on December 31, 2023. This code has a pricing indicator code of 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 this code is not established.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9612 may vary. It is important to check with the specific payer to determine if the service is payable and to understand the pricing and coverage details. The pricing indicator code of 00 indicates that the service is not separately priced by Part B, and the multiple pricing indicator code of 9 indicates that the value is not established.

8. Examples

Here are five examples of when HCPCS code G9612 should be billed:

  1. A gastroenterologist performs a colonoscopy and captures images of the cecal landmarks for documentation purposes.
  2. A surgeon performs a laparoscopic procedure and uses photodocumentation to establish the location of the cecal landmarks.
  3. A radiologist performs a virtual colonoscopy and captures images of the cecal landmarks to ensure a complete examination.
  4. A gastroenterologist performs a follow-up examination and documents the cecal landmarks using photodocumentation.
  5. A physician performs a diagnostic procedure and includes photodocumentation of the cecal landmarks for comprehensive documentation.

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