How To Use HCPCS Code G9722

HCPCS code G9722 describes a specific condition related to renal failure or elevated serum creatinine levels. This code is used to document the history of renal failure or a baseline serum creatinine level of 4.0 mg/dl or higher. It is important to note that renal transplant recipients are not considered to have preoperative renal failure unless their serum creatinine level has been or is 4.0 mg/dl or higher since the transplantation.

1. What is HCPCS G9722?

HCPCS code G9722 is a specific code used in medical coding to identify patients with a documented history of renal failure or a baseline serum creatinine level of 4.0 mg/dl or higher. This code helps healthcare providers accurately document and track patients with renal failure or elevated creatinine levels for billing and reimbursement purposes.

2. Official Description

The official description of HCPCS code G9722 is “Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher.” The short description is “Doc hx renal fail or cr+ >=4.”

3. Procedure

  1. Patients with a documented history of renal failure or a baseline serum creatinine level of 4.0 mg/dl or higher should be identified.
  2. Healthcare providers should review the patient’s medical records to confirm the documented history of renal failure or elevated creatinine levels.
  3. The code G9722 should be assigned to the patient’s medical record to accurately reflect their condition.

4. When to use HCPCS code G9722

HCPCS code G9722 should be used when a patient has a documented history of renal failure or a baseline serum creatinine level of 4.0 mg/dl or higher. It is important to note that renal transplant recipients are not considered to have preoperative renal failure unless their serum creatinine level has been or is 4.0 mg/dl or higher since the transplantation.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G9722, healthcare providers should ensure that the patient’s medical records clearly document the history of renal failure or the baseline serum creatinine level of 4.0 mg/dl or higher. This documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9722 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of January 01, 2021, 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 for HCPCS code G9722 is determined by the carrier’s judgment. Medicare and other insurance providers may have specific guidelines and policies regarding the reimbursement for services associated with this code. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of when HCPCS code G9722 should be billed:

  1. A patient with a documented history of renal failure undergoes a medical procedure.
  2. A patient with a baseline serum creatinine level of 4.5 mg/dl is admitted to the hospital for further evaluation.
  3. A renal transplant recipient develops elevated serum creatinine levels of 4.2 mg/dl post-transplantation.
  4. A patient with a history of renal failure receives ongoing dialysis treatment.
  5. A patient with a baseline serum creatinine level of 4.1 mg/dl undergoes a diagnostic imaging study.

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