How To Use HCPCS Code G9763

HCPCS code G9763 describes the situation where a patient did not receive at least two HPV vaccines with a minimum of 146 days between the two doses, or three HPV vaccines between the patient’s 9th and 13th birthdays. This code is used to indicate that the patient has not completed the recommended vaccination schedule for HPV.

1. What is HCPCS G9763?

HCPCS code G9763 is a specific code used in medical coding to identify the situation where a patient has not received the recommended number of HPV vaccines. This code is important for tracking and monitoring the vaccination status of patients, particularly in relation to the prevention of HPV-related diseases.

2. Official Description

The official description of HCPCS code G9763 is “Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient’s 9th and 13th birthdays.” The short description for this code is “Pt not have 2-3 HPV vaccines.”

3. Procedure

1. The healthcare provider should review the patient’s medical records to determine if they have received the recommended number of HPV vaccines.
2. If the patient has not received at least two HPV vaccines with a minimum of 146 days between the two doses, or three HPV vaccines between their 9th and 13th birthdays, the provider should assign HCPCS code G9763 to indicate the incomplete vaccination status.
3. This code should be documented accurately in the patient’s medical records and included in the billing information.

4. When to use HCPCS code G9763

HCPCS code G9763 should be used when a patient has not received the recommended number of HPV vaccines. This code is applicable when the patient has not received at least two HPV vaccines with a minimum of 146 days between the two doses, or three HPV vaccines between their 9th and 13th birthdays. It is important to use this code to accurately reflect the patient’s vaccination status and to ensure proper tracking and monitoring of HPV vaccination rates.

5. Billing Guidelines and Documentation Requirements

When billing for services related to HCPCS code G9763, healthcare providers should ensure that the code is accurately documented in the patient’s medical records. The documentation should clearly indicate that the patient has not received the recommended number of HPV vaccines. This information is crucial for proper billing and reimbursement processes.

6. Historical Information and Code Maintenance

HCPCS code G9763 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of the effective date of January 01, 2018, 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 remains relevant for tracking and monitoring the vaccination status of patients.

7. Medicare and Insurance Coverage

The coverage for HCPCS code G9763 is determined by the carrier judgment, as indicated by the coverage code C. This means that the coverage and reimbursement for this code may vary depending on the specific insurance carrier. It is important for healthcare providers to check with the patient’s insurance provider to determine the coverage and reimbursement policies for this code.

8. Examples

Here are five examples of when HCPCS code G9763 should be billed:

1. A 12-year-old patient who has only received one HPV vaccine and has not yet completed the recommended vaccination schedule.
2. A 15-year-old patient who has not received any HPV vaccines and is not up to date with the recommended vaccination schedule.
3. A 10-year-old patient who has received two HPV vaccines, but the doses were administered within a period of less than 146 days.
4. A 14-year-old patient who has received two HPV vaccines, but the doses were administered after their 13th birthday.
5. A 9-year-old patient who has not yet received any HPV vaccines and is due for their first dose.