How To Use HCPCS Code G9759

HCPCS code G9759 describes the history of preoperative posterior capsule rupture. This code is used to indicate that a patient has experienced a rupture of the posterior capsule during a previous surgical procedure. In this article, we will explore the details of HCPCS code G9759, 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 G9759?

HCPCS code G9759 is a specific code used in medical coding to identify the history of preoperative posterior capsule rupture. It is important to note that this code is specific to the occurrence of a rupture in the posterior capsule prior to a surgical procedure.

2. Official Description

The official description of HCPCS code G9759 is “History of preoperative posterior capsule rupture.” The short description for this code is “Hx preop post cap rup.”

3. Procedure

  1. The procedure for HCPCS code G9759 involves documenting the patient’s medical history and identifying any instances of preoperative posterior capsule rupture.
  2. The provider should review the patient’s medical records and surgical history to determine if there has been a previous occurrence of posterior capsule rupture.
  3. If a rupture is identified, it should be documented in the patient’s medical record along with any relevant details, such as the date of the rupture and the surgical procedure during which it occurred.

4. When to use HCPCS code G9759

HCPCS code G9759 should be used when a patient has a documented history of preoperative posterior capsule rupture. This code is specific to instances where the rupture occurred prior to a surgical procedure. It is important to accurately document and code this history to ensure proper reimbursement and accurate medical records.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9759, healthcare providers should ensure that the patient’s medical record clearly documents the history of preoperative posterior capsule rupture. This documentation should include the date of the rupture, the surgical procedure during which it occurred, and any relevant details or complications associated with the rupture.

6. Historical Information and Code Maintenance

HCPCS code G9759 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of December 31, 2020, this code has been terminated. The termination of a code means that it is no longer valid for use in medical coding and billing.

7. Medicare and Insurance Coverage

The coverage for HCPCS code G9759 is determined by the carrier judgment. This means that the decision to cover or reimburse for this code is made by the insurance carrier based on their own policies and guidelines. It is important for healthcare providers to verify coverage with the patient’s insurance carrier before submitting a claim.

8. Examples

Here are five examples of when HCPCS code G9759 should be billed:

  1. A patient undergoes cataract surgery and has a documented history of preoperative posterior capsule rupture.
  2. A patient is scheduled for a surgical procedure, and during the preoperative evaluation, it is discovered that they have previously experienced a rupture of the posterior capsule.
  3. A patient presents for a follow-up visit after a previous surgical procedure, and the medical record indicates a history of preoperative posterior capsule rupture.
  4. A patient is referred to a specialist for further evaluation and treatment of a preoperative posterior capsule rupture that occurred during a previous surgical procedure.
  5. A patient’s medical record indicates a history of preoperative posterior capsule rupture, and this information is relevant to their current treatment plan or surgical decision-making process.

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