How To Use HCPCS Code G9699

HCPCS code G9699 describes a long-acting inhaled bronchodilator that has not been prescribed, with the reason not otherwise specified. This code is used to identify situations where a patient is not prescribed a long-acting inhaled bronchodilator, but the specific reason for not prescribing it is not provided. In this article, we will explore the details of HCPCS code G9699, 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 G9699?

HCPCS code G9699 is used to identify a long-acting inhaled bronchodilator that has not been prescribed, with the reason not otherwise specified. It is important to note that this code specifically refers to situations where the bronchodilator has not been prescribed, but the reason for not prescribing it is not provided. This code helps in capturing data related to the use of long-acting inhaled bronchodilators in patient care.

2. Official Description

The official description of HCPCS code G9699 is “Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified.” The short description for this code is “Long inhal bronchdil no pres.” This description accurately reflects the purpose of the code, indicating that a long-acting inhaled bronchodilator has not been prescribed, without specifying the reason for non-prescription.

3. Procedure

  1. During the patient encounter, the healthcare provider assesses the patient’s respiratory condition and determines the need for a long-acting inhaled bronchodilator.
  2. If the provider decides not to prescribe a long-acting inhaled bronchodilator for the patient, they should document the reason for not prescribing it, if available.
  3. The provider should then assign HCPCS code G9699 to indicate that a long-acting inhaled bronchodilator has not been prescribed, with the reason not otherwise specified.

4. When to use HCPCS code G9699

HCPCS code G9699 should be used in situations where a long-acting inhaled bronchodilator has not been prescribed for a patient, and the reason for non-prescription is not provided. It is important to accurately document the absence of prescription and the lack of specific reason to ensure proper coding and data collection.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9699, healthcare providers should ensure proper documentation to support the use of this code. The documentation should clearly indicate that a long-acting inhaled bronchodilator has not been prescribed for the patient, without specifying the reason for non-prescription. Providers should follow the billing guidelines provided by the payer to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9699 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. This code has an HCPCS pricing indicator code of 00, which indicates that the service is not separately priced by Part B. The multiple pricing indicator code for this code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9699 may vary. Providers should refer to the payer’s guidelines and policies to determine if this code is payable. The pricing indicator code of 00 suggests that the service is not separately priced by Part B and may not be covered or reimbursed separately. It is important to verify coverage and reimbursement policies with the specific payer to ensure accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code G9699 should be billed:

  1. A patient with a history of respiratory conditions visits their healthcare provider for a routine check-up. The provider assesses the patient’s condition and decides not to prescribe a long-acting inhaled bronchodilator, without specifying the reason. HCPCS code G9699 should be billed to indicate the absence of prescription.
  2. A patient presents with mild respiratory symptoms, and the healthcare provider determines that a long-acting inhaled bronchodilator is not necessary at the time. The provider documents the lack of prescription without specifying the reason. HCPCS code G9699 should be used in this case.
  3. During a hospital stay, a patient’s respiratory condition improves, and the healthcare provider decides not to prescribe a long-acting inhaled bronchodilator. The provider documents the absence of prescription without providing a specific reason. HCPCS code G9699 should be assigned in this scenario.
  4. A patient with a history of respiratory conditions visits an urgent care facility for acute symptoms. The healthcare provider determines that a long-acting inhaled bronchodilator is not necessary for immediate relief and decides not to prescribe it. HCPCS code G9699 should be used to indicate the lack of prescription.
  5. A patient with a respiratory condition visits a specialist for a consultation. After evaluating the patient’s medical history and current symptoms, the specialist decides not to prescribe a long-acting inhaled bronchodilator, without specifying the reason. HCPCS code G9699 should be billed in this case.

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