How To Use HCPCS Code G9672

HCPCS code G9672 describes the completion of all quality actions for the applicable measures in the diabetic retinopathy measures group for a specific patient. This code is used to indicate that all necessary actions have been taken to address the diabetic retinopathy measures for the patient in question. In this article, we will delve into the details of HCPCS code G9672, including its official description, procedure, when to use it, billing guidelines and documentation requirements, historical information and code maintenance, Medicare and insurance coverage, as well as provide examples of when this code should be billed.

1. What is HCPCS G9672?

HCPCS code G9672 is a specific code used to indicate that all quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for a particular patient. It signifies that the necessary steps have been taken to address the diabetic retinopathy measures for the patient in question.

2. Official Description

The official description of HCPCS code G9672 is “All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient.” The short description for this code is “Qty act diab retin mg perf.”

3. Procedure

1. As HCPCS code G9672 represents the completion of all quality actions for the applicable measures in the diabetic retinopathy measures group, the procedure involves ensuring that all necessary actions have been taken to address the diabetic retinopathy measures for the specific patient.
2. This may include performing diagnostic tests, providing appropriate treatments or interventions, and monitoring the patient’s progress.
3. The healthcare provider must ensure that all quality actions related to the diabetic retinopathy measures have been completed and documented accurately.

4. When to use HCPCS code G9672

HCPCS code G9672 should be used when all quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for a specific patient. It indicates that the necessary steps have been taken to address the diabetic retinopathy measures for the patient in question.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9672, healthcare providers need to ensure that all relevant documentation is complete and accurate. This includes documenting the completion of all quality actions for the applicable measures in the diabetic retinopathy measures group for the specific patient.

6. Historical Information and Code Maintenance

HCPCS code G9672 was added to the Healthcare Common Procedure Coding System on January 1, 2016. It has an action effective date of January 1, 2017. The code does not require any maintenance, as indicated by the action code N, which means no maintenance for this code. It is important to note that HCPCS code G9672 was terminated on December 31, 2016.

7. Medicare and Insurance Coverage

HCPCS code G9672 is covered by Medicare and may be reimbursed according to the carrier’s judgment. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. It is important to check with individual insurance providers regarding coverage and reimbursement for HCPCS code G9672.

8. Examples

Here are five examples of scenarios in which HCPCS code G9672 should be billed:

1. A patient with diabetes undergoes all necessary diagnostic tests for diabetic retinopathy and receives appropriate treatment based on the results.
2. A healthcare provider completes all quality actions for the applicable measures in the diabetic retinopathy measures group for a patient with diabetes.
3. A patient with diabetes receives regular monitoring and follow-up for diabetic retinopathy, with all necessary actions performed.
4. A healthcare provider ensures that all quality actions for the applicable measures in the diabetic retinopathy measures group have been completed for a patient with diabetes.
5. A patient with diabetes receives comprehensive care for diabetic retinopathy, including all necessary actions to address the measures in the diabetic retinopathy measures group.