How To Use HCPCS Code G9749

HCPCS code G9749 describes a specific procedure known as palliative dialysis with a catheter. This code is used to identify and bill for the provision of palliative dialysis services to patients who require dialysis treatment using a catheter. In this article, we will explore the details of HCPCS code G9749, 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 G9749?

HCPCS code G9749 is a unique alphanumeric code that is used to identify and describe a specific medical procedure or service. In the case of G9749, it represents palliative dialysis with a catheter. This code is essential for medical coders and billers to accurately document and bill for the services provided to patients undergoing palliative dialysis with a catheter.

2. Official Description

The official description of HCPCS code G9749 is “Patient is undergoing palliative dialysis with a catheter.” This description clearly indicates that the code is specifically used to identify patients who are receiving palliative dialysis treatment using a catheter.

3. Procedure

  1. The procedure for palliative dialysis with a catheter involves several steps:
  2. Preparation: The healthcare provider ensures that the patient is in a suitable position for the procedure and prepares the necessary equipment.
  3. Catheter insertion: The provider inserts a catheter into the patient’s body, typically in the chest or abdomen, to access the blood vessels for dialysis.
  4. Connection to dialysis machine: The catheter is connected to a dialysis machine, which filters the patient’s blood to remove waste products and excess fluid.
  5. Monitoring: The provider closely monitors the patient’s vital signs and adjusts the dialysis parameters as needed.
  6. Completion: Once the dialysis session is complete, the catheter is carefully removed, and the insertion site is appropriately dressed and monitored for any complications.

4. When to use HCPCS code G9749

HCPCS code G9749 should be used when a patient is undergoing palliative dialysis with a catheter. Palliative dialysis is a type of dialysis that is provided to patients with end-stage renal disease (ESRD) who have chosen not to pursue kidney transplantation or long-term dialysis. The use of a catheter for dialysis access is common in palliative care settings, where the focus is on providing comfort and symptom management rather than long-term treatment.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9749, healthcare providers need to ensure accurate documentation of the palliative dialysis procedure with a catheter. This includes documenting the patient’s medical condition, the reason for choosing palliative dialysis, the specific details of the catheter insertion and removal, and any complications or additional services provided during the dialysis session. It is crucial to follow the specific billing guidelines provided by Medicare or other insurance carriers to ensure proper reimbursement for the services rendered.

6. Historical Information and Code Maintenance

HCPCS code G9749 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 still an active code. As of December 31, 2020, this code was terminated, meaning it is no longer valid for billing purposes. It is essential for medical coders and billers to stay updated on code maintenance actions to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

Medicare and other insurance carriers may provide coverage for palliative dialysis with a catheter, depending on the patient’s specific medical condition and the terms of their insurance policy. The pricing indicator code for HCPCS code G9749 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. It is crucial to verify the coverage and reimbursement policies of each insurance carrier to ensure proper billing and reimbursement.

8. Examples

Here are some examples of scenarios where HCPCS code G9749 should be billed:

  1. Example 1: A 75-year-old patient with end-stage renal disease (ESRD) who has chosen palliative care receives dialysis treatment using a catheter.
  2. Example 2: A hospice patient with advanced kidney disease undergoes palliative dialysis with a catheter to manage symptoms and improve comfort.
  3. Example 3: A patient with a terminal illness requires palliative dialysis with a catheter to maintain adequate fluid balance and alleviate discomfort.
  4. Example 4: A patient with multiple comorbidities, including ESRD, receives palliative dialysis with a catheter as part of their overall end-of-life care plan.
  5. Example 5: A patient with a history of failed kidney transplants opts for palliative dialysis with a catheter to manage their renal function without pursuing further aggressive treatment.

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