How To Use HCPCS Code G9638

HCPCS code G9638 describes the final reports without documentation of one or more dose reduction techniques. This code is used to indicate that the provider did not include any documentation of dose reduction techniques such as automated exposure control, adjustment of the ma and/or kv according to patient size, or the use of iterative reconstruction technique.

1. What is HCPCS G9638?

HCPCS code G9638 is a specific code used in medical coding to identify cases where the final reports do not include documentation of one or more dose reduction techniques. It is important for medical coders to accurately assign this code to ensure proper billing and reimbursement.

2. Official Description

The official description of HCPCS code G9638 is “Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)”. The short description for this code is “No doc >1 dose reduc tech”.

3. Procedure

  1. The provider should review the final reports of the procedure.
  2. Check if there is any documentation of dose reduction techniques such as automated exposure control, adjustment of the ma and/or kv according to patient size, or the use of iterative reconstruction technique.
  3. If there is no documentation of any of these dose reduction techniques, assign HCPCS code G9638.

4. When to use HCPCS code G9638

HCPCS code G9638 should be used when the final reports of a procedure do not include any documentation of one or more dose reduction techniques. It is important to accurately assess the documentation and assign the appropriate code to ensure proper billing and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9638, healthcare providers should ensure that the final reports clearly indicate the absence of documentation for one or more dose reduction techniques. It is important to accurately document the lack of these techniques to support the use of this code for billing purposes.

6. Historical Information and Code Maintenance

HCPCS code G9638 was added to the Healthcare Common Procedure Coding System on January 01, 2016. As of the effective date, 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 coverage for HCPCS code G9638 is determined by carrier judgment, as indicated by the coverage code C. It is important to check with individual insurance providers to determine coverage and reimbursement policies for this specific code.

8. Examples

Here are five examples of cases where HCPCS code G9638 should be billed:

  1. A radiology report for a CT scan does not include any documentation of automated exposure control or adjustment of the ma and/or kv according to patient size.
  2. A final report for a mammogram does not indicate the use of iterative reconstruction technique.
  3. A nuclear medicine study report does not include any documentation of dose reduction techniques.
  4. A final report for a PET scan does not indicate the use of automated exposure control.
  5. A radiology report for an X-ray does not include any documentation of adjustment of the ma and/or kv according to patient size.

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