How To Use HCPCS Code G9630

HCPCS code G9630 describes a specific scenario where a patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery. This code is used to indicate that there was no bowel injury during the surgical procedure and that no complications related to the bowel were identified within the 30-day post-operative period.

1. What is HCPCS G9630?

HCPCS code G9630 is a specific code used in medical coding to identify the absence of a bowel injury during surgery and within the 30-day post-operative period. It provides important information about the patient’s condition and helps in accurately documenting and billing for the services provided.

2. Official Description

The official description of HCPCS code G9630 is “Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery.” The short description for this code is “Pt no bwli srg 30 day srg.”

3. Procedure

1. The healthcare provider performs the surgical procedure as required for the patient.
2. During the surgery, the provider takes necessary precautions to avoid any bowel injury.
3. After the surgery, the patient is closely monitored for any signs or symptoms of bowel injury.
4. If no bowel injury is identified during the surgery and within the 30-day post-operative period, HCPCS code G9630 is assigned to indicate the absence of such injury.

4. When to use HCPCS code G9630

HCPCS code G9630 should be used when the patient did not sustain a bowel injury during the surgical procedure and no complications related to the bowel were discovered within the 30-day post-operative period. It is important to accurately document the absence of bowel injury to ensure proper coding and billing.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G9630, healthcare providers need to document the absence of bowel injury during the surgery and within the 30-day post-operative period. This documentation should include details of the surgical procedure performed, any precautions taken to avoid bowel injury, and the absence of any complications related to the bowel. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9630 was added to the Healthcare Common Procedure Coding System on January 01, 2016. As of the effective date of January 01, 2019, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has a pricing indicator code of 00, which indicates that the service is not separately priced by Part B.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the services associated with HCPCS code G9630, but it is important to check with the specific payer for their coverage policies. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that 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 G9630 would be used:

1. A patient undergoes a surgical procedure, and during the surgery, the healthcare provider ensures that no bowel injury occurs. The patient recovers without any complications related to the bowel within the 30-day post-operative period.
2. A patient undergoes an emergency surgery, and despite the urgency, the healthcare provider takes necessary precautions to avoid any bowel injury. The patient does not experience any complications related to the bowel within the 30-day post-operative period.
3. A patient undergoes a complex surgical procedure involving multiple organs, including the bowel. The healthcare provider successfully avoids any bowel injury during the surgery, and the patient recovers without any complications related to the bowel within the 30-day post-operative period.
4. A patient undergoes a laparoscopic surgery, which carries a lower risk of bowel injury compared to open surgery. The healthcare provider confirms the absence of bowel injury during the procedure, and the patient does not experience any complications related to the bowel within the 30-day post-operative period.
5. A patient undergoes a surgical procedure, and the healthcare provider takes extra precautions to minimize the risk of bowel injury. The patient’s recovery is uneventful, with no complications related to the bowel identified within the 30-day post-operative period.