How To Use HCPCS Code G9675

HCPCS code G9675 describes patients who have ever had a fasting or direct laboratory result of LDL-C (low-density lipoprotein cholesterol) equal to or greater than 190 mg/dL. This code is used to identify and track patients who have high levels of LDL-C, which is often referred to as “bad” cholesterol. By using this code, healthcare providers can ensure that these patients receive appropriate monitoring and treatment to manage their cholesterol levels and reduce the risk of cardiovascular disease.

1. What is HCPCS G9675?

HCPCS code G9675 is a specific code used in medical coding to identify patients who have ever had a fasting or direct laboratory result of LDL-C equal to or greater than 190 mg/dL. It is important to note that this code does not provide any specific treatment or procedure information, but rather serves as a marker for patients with high LDL-C levels.

2. Official Description

The official description of HCPCS code G9675 is “Patients who have ever had a fasting or direct laboratory result of LDL-C equal to 190 mg/dL.” The short description for this code is “Pt w/fast/dir lab LDL-C >190.”

3. Procedure

  1. There is no specific procedure associated with HCPCS code G9675. This code is used to identify patients based on their laboratory results for LDL-C.

4. When to use HCPCS code G9675

HCPCS code G9675 should be used when documenting and coding for patients who have ever had a fasting or direct laboratory result of LDL-C equal to or greater than 190 mg/dL. This code helps healthcare providers track and monitor patients with high LDL-C levels, allowing for appropriate management and treatment.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9675, healthcare providers should ensure that the patient’s medical records clearly document the fasting or direct laboratory result of LDL-C equal to or greater than 190 mg/dL. This documentation is essential for accurate coding and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9675 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.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G9675 may vary depending on the carrier judgment. It is important for healthcare providers to check with Medicare or other insurance carriers to determine the specific coverage and reimbursement policies for this code.

8. Examples

Here are five examples of when HCPCS code G9675 should be billed:

  1. A patient presents with a fasting laboratory result of LDL-C equal to 200 mg/dL.
  2. A patient’s direct laboratory result of LDL-C is 210 mg/dL.
  3. A patient’s fasting laboratory result of LDL-C is 195 mg/dL.
  4. A patient has a history of a direct laboratory result of LDL-C equal to 220 mg/dL.
  5. A patient’s fasting laboratory result of LDL-C is 205 mg/dL.

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