How To Use HCPCS Code G9614

HCPCS code G9614 describes the photodocumentation of less than two cecal landmarks to establish a complete examination. This code is used in medical coding to identify the specific procedure performed by healthcare providers. In this article, we will explore the details of HCPCS code G9614, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples.

1. What is HCPCS G9614?

HCPCS code G9614 is a specific code used to identify the photodocumentation of less than two cecal landmarks. It is important to note that this code is used to establish a complete examination when there are no cecal landmarks or only one cecal landmark present. The purpose of this code is to accurately document the visual examination of the colon and provide a comprehensive record for medical purposes.

2. Official Description

The official description of HCPCS code G9614 is “Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination.” This description precisely defines the procedure that is being coded.

3. Procedure

1. The provider begins by preparing the patient for the examination, ensuring their comfort and privacy.
2. Using appropriate equipment, the provider captures images or photographs of the colon.
3. The provider carefully examines the images to identify the presence or absence of cecal landmarks.
4. If there are no cecal landmarks or only one cecal landmark visible in the images, the provider documents this information.
5. The provider ensures that the photodocumentation accurately represents the examination and is suitable for medical purposes.

4. When to use HCPCS code G9614

HCPCS code G9614 should be used when the photodocumentation of less than two cecal landmarks is necessary to establish a complete examination. This code is applicable when there are no cecal landmarks or only one cecal landmark visible in the images captured during the examination. It is important to follow the specific eligibility criteria and guidelines for using this code to ensure accurate coding and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9614, healthcare providers need to document the photodocumentation of less than two cecal landmarks in the patient’s medical record. This documentation should clearly indicate the absence of cecal landmarks or the presence of only one cecal landmark. Additionally, providers should ensure that the images or photographs captured during the examination accurately represent the findings and are suitable for medical purposes.

6. Historical Information and Code Maintenance

HCPCS code G9614 was added to the Healthcare Common Procedure Coding System on January 01, 2016. It is important to note that this code is terminated effective December 31, 2023. No maintenance actions have been taken for this code, as indicated by the action code D, which means the procedure or modifier code has been discontinued.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9614 may vary. It is essential to consult the specific guidelines and policies of the respective payers to determine the coverage and reimbursement for this procedure. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. 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.

8. Examples

Here are five examples of scenarios where HCPCS code G9614 should be billed:

1. A patient undergoes a colonoscopy, and the photodocumentation reveals no cecal landmarks.
2. During a sigmoidoscopy, the provider captures images that show only one cecal landmark.
3. A virtual colonoscopy is performed, and the images obtained do not display any cecal landmarks.
4. Following a barium enema, the photodocumentation indicates the absence of cecal landmarks.
5. During a flexible sigmoidoscopy, the provider documents the presence of only one cecal landmark in the images captured.