HCPCS code G9747 describes the use of a catheter for palliative dialysis in patients. This code is used to identify the specific procedure being performed and is essential for accurate medical coding and billing. In this article, we will explore the details of HCPCS code G9747, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples for better understanding.
1. What is HCPCS G9747?
HCPCS code G9747 is used to indicate that a patient is undergoing palliative dialysis with a catheter. Palliative dialysis refers to the provision of dialysis treatment to patients with end-stage renal disease (ESRD) who have chosen not to pursue kidney transplantation or long-term dialysis. The catheter is a tube inserted into a vein to allow for the removal and return of blood during the dialysis process.
2. Official Description
The official description of HCPCS code G9747 is “Patient is undergoing palliative dialysis with a catheter.” This description accurately represents the purpose of the code and provides a clear understanding of the procedure being performed.
3. Procedure
- The procedure of HCPCS code G9747 involves the insertion of a catheter into a suitable vein of the patient.
- The catheter is carefully placed to ensure proper blood flow during the dialysis process.
- The dialysis machine is then connected to the catheter, allowing for the removal of waste products and excess fluid from the patient’s blood.
- The cleaned blood is then returned to the patient’s body through the same catheter.
- This process is repeated as necessary to maintain the patient’s overall health and well-being.
4. When to use HCPCS code G9747
HCPCS code G9747 should be used when a patient is undergoing palliative dialysis with a catheter. It is important to note that this code is specifically for palliative dialysis and not for other types of dialysis procedures or interventions. The use of this code indicates that the patient has chosen palliative care for their end-stage renal disease and is receiving dialysis treatment through a catheter.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code G9747, healthcare providers need to ensure accurate documentation of the procedure and the medical necessity for palliative dialysis with a catheter. The medical record should include details such as the patient’s diagnosis, the reason for choosing palliative care, and any other relevant information supporting the need for this specific procedure. Additionally, providers should follow the billing guidelines set forth by the payer, ensuring proper coding and submission of claims.
6. Historical Information and Code Maintenance
HCPCS code G9747 was added to the Healthcare Common Procedure Coding System on January 01, 2017. It has an effective date of January 01, 2021, indicating that it is currently in use. As of December 31, 2020, this code was terminated, meaning it is no longer valid for billing purposes. It is important for medical coders and billers to stay updated on code changes and ensure the use of the most current codes for accurate reimbursement.
7. Medicare and Insurance Coverage
Medicare and other insurance providers may cover the palliative dialysis procedure with a catheter, as indicated by the HCPCS coverage code C, which stands for Carrier judgment. However, the pricing indicator code for HCPCS code G9747 is 00, which means the service is not separately priced by Part B. This indicates that the service may be bundled or not covered separately, and reimbursement may be included in other related services or procedures. It is crucial to verify coverage and reimbursement policies with the specific payer to ensure proper billing and reimbursement.
8. Examples
Here are a few examples to illustrate the appropriate use of HCPCS code G9747:
- Example 1: A patient with end-stage renal disease has chosen palliative care and is receiving dialysis treatment through a catheter. The healthcare provider documents the procedure and submits a claim with HCPCS code G9747.
- Example 2: A patient with end-stage renal disease is undergoing regular dialysis but does not meet the criteria for palliative care. In this case, HCPCS code G9747 would not be used.
- Example 3: A patient with end-stage renal disease is receiving dialysis treatment through a fistula instead of a catheter. HCPCS code G9747 would not be appropriate in this scenario.
- Example 4: A patient with end-stage renal disease has chosen palliative care and is receiving dialysis treatment through a catheter. However, the procedure is performed after the termination date of HCPCS code G9747. In this case, an appropriate alternative code should be used.
- Example 5: A patient with end-stage renal disease is receiving dialysis treatment through a catheter, but the procedure is not considered palliative. HCPCS code G9747 would not be applicable in this situation.
