How To Use HCPCS Code G9674

HCPCS code G9674 describes patients with a clinical diagnosis of atherosclerotic cardiovascular disease (ASCVD). This code is used to identify individuals who have been diagnosed with ASCVD and require medical care related to their condition. In this article, we will explore the details of HCPCS code G9674, 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 G9674?

HCPCS code G9674 is used to identify patients with a clinical diagnosis of ASCVD. ASCVD refers to the buildup of plaque in the arteries, which can lead to various cardiovascular conditions such as heart attacks and strokes. This code is specifically used to indicate that the patient has been diagnosed with ASCVD and requires medical care related to their condition.

2. Official Description

The official description of HCPCS code G9674 is “Pt w/clin ascvd dx.” This description indicates that the code is used to identify patients with a clinical diagnosis of ASCVD.

3. Procedure

  1. There is no specific procedure associated with HCPCS code G9674. Instead, this code is used to indicate the presence of a clinical diagnosis of ASCVD in a patient.

4. When to use HCPCS code G9674

HCPCS code G9674 should be used when a patient has a clinical diagnosis of ASCVD. This means that the patient has been diagnosed with ASCVD by a healthcare provider based on their medical history, physical examination, and diagnostic tests. It is important to accurately document the clinical diagnosis of ASCVD in the patient’s medical records before using this code for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for services or supplies related to HCPCS code G9674, healthcare providers need to ensure that the patient’s medical records clearly document the clinical diagnosis of ASCVD. This documentation should include details of the diagnostic tests performed, the healthcare provider’s assessment of the patient’s condition, and any treatment or management plans implemented.

6. Historical Information and Code Maintenance

HCPCS code G9674 was added to the Healthcare Common Procedure Coding System on January 01, 2016. Since its addition, 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 suggests that the code has remained unchanged since its introduction.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G9674 by Medicare and other insurance providers may vary. It is important for healthcare providers to verify the coverage policies of the specific payer before submitting claims using this code. The pricing indicator code for HCPCS code G9674 is 00, which indicates that the service is not separately priced by Part B. This means that the service or supply associated with this code may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G9674 should be billed:

  1. A patient with a history of ASCVD presents with chest pain and is diagnosed with a myocardial infarction (heart attack). HCPCS code G9674 should be used to indicate the clinical diagnosis of ASCVD in this case.
  2. A patient with a clinical diagnosis of ASCVD undergoes a coronary angioplasty procedure to open a blocked artery. HCPCS code G9674 should be used to indicate the presence of ASCVD in this patient.
  3. A patient with a clinical diagnosis of ASCVD is prescribed statin medication for cholesterol management. HCPCS code G9674 should be used to indicate the clinical diagnosis of ASCVD in this case.
  4. A patient with a clinical diagnosis of ASCVD receives cardiac rehabilitation services to improve their cardiovascular health. HCPCS code G9674 should be used to indicate the presence of ASCVD in this patient.
  5. A patient with a clinical diagnosis of ASCVD undergoes a carotid endarterectomy procedure to remove plaque from the carotid artery. HCPCS code G9674 should be used to indicate the clinical diagnosis of ASCVD in this case.

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