How To Use HCPCS Code G9689

HCPCS code G9689 describes a patient who is admitted for the performance of elective carotid intervention. This code is used to identify the specific procedure and services provided during the intervention. In this article, we will explore the details of HCPCS code G9689, 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 G9689?

HCPCS code G9689 is used to identify a patient who is admitted for the performance of elective carotid intervention. This code specifically refers to the inpatient setting and indicates that the intervention is elective, meaning it is planned and not an emergency procedure.

2. Official Description

The official description of HCPCS code G9689 is “Patient admitted for performance of elective carotid intervention.” The short description is “Inpt elect carotid intervent.”

3. Procedure

  1. The provider begins by assessing the patient’s medical history and conducting a physical examination to determine the need for a carotid intervention.
  2. If the patient meets the criteria for the procedure, the provider will schedule the intervention as an elective procedure.
  3. On the day of the procedure, the patient is admitted to the hospital and prepared for the intervention.
  4. The provider performs the carotid intervention, which may involve techniques such as carotid endarterectomy or carotid stenting.
  5. After the procedure, the patient is closely monitored for any complications or adverse reactions.
  6. Once the patient has recovered sufficiently, they may be discharged from the hospital.

4. When to use HCPCS code G9689

HCPCS code G9689 should be used when a patient is admitted to the hospital for the performance of an elective carotid intervention. It is important to note that this code is specific to inpatient settings and should not be used for outpatient or emergency procedures.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9689, healthcare providers need to ensure that the documentation supports the need for the elective carotid intervention. This may include the patient’s medical history, diagnostic test results, and any other relevant information that justifies the procedure. Additionally, providers should follow the appropriate coding and billing guidelines set forth by Medicare or other insurance payers.

6. Historical Information and Code Maintenance

HCPCS code G9689 was added to the Healthcare Common Procedure Coding System on January 01, 2017. 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

Medicare and other insurance providers may cover the elective carotid intervention identified by HCPCS code G9689. However, it is important to verify coverage with the specific payer and understand any limitations or requirements for reimbursement. The pricing indicator code for HCPCS code G9689 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare. The multiple pricing indicator code is 9, which means that the value for this code is not established.

8. Examples

Here are five examples of when HCPCS code G9689 should be billed:

  1. A 65-year-old patient with a history of carotid artery stenosis is admitted to the hospital for an elective carotid endarterectomy.
  2. A 70-year-old patient with a recent transient ischemic attack (TIA) is scheduled for an elective carotid stenting procedure to prevent future strokes.
  3. A 55-year-old patient with symptomatic carotid artery disease is admitted for an elective carotid intervention to improve blood flow to the brain.
  4. A 75-year-old patient with a history of multiple carotid artery blockages undergoes an elective carotid intervention to reduce the risk of stroke.
  5. A 60-year-old patient with a carotid artery aneurysm is admitted for an elective carotid intervention to repair the aneurysm and prevent rupture.

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