How To Use HCPCS Code G9820

HCPCS code G9820 describes the documentation of a chlamydia screening test with proper follow-up. This code is used to identify the specific service provided by healthcare providers in relation to chlamydia screening and the subsequent actions taken based on the results. In this article, we will explore the details of HCPCS code G9820, 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 G9820?

HCPCS code G9820 is used to document a chlamydia screening test with proper follow-up. It is important for healthcare providers to accurately report this code when performing and documenting the screening test and any subsequent actions taken based on the results. By using this code, providers can ensure proper reimbursement for the services rendered.

2. Official Description

The official description of HCPCS code G9820 is “Documentation of a chlamydia screening test with proper follow-up.” The short description for this code is “Doc chlam scr test w/follow.”

3. Procedure

1. Perform the chlamydia screening test on the patient.
2. Document the results of the screening test.
3. Based on the results, provide appropriate follow-up care or treatment.
4. Document the follow-up actions taken, including any referrals or additional tests.

4. When to use HCPCS code G9820

HCPCS code G9820 should be used when healthcare providers perform a chlamydia screening test and properly document the results. It is important to use this code in the context of chlamydia screening specifically, and not for other types of tests or screenings. Providers should follow the guidelines and eligibility criteria set forth by relevant medical associations and insurance payers when determining the appropriate use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9820, healthcare providers need to ensure that they have documented the chlamydia screening test and any follow-up actions taken. The documentation should include the date of the screening test, the results, and any subsequent care or treatment provided. It is important to accurately code and bill for the services rendered to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9820 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important for healthcare providers to stay updated on any changes or revisions to the code in order to accurately report and bill for the services provided.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code G9820 may vary depending on the payer. Medicare and other insurance providers may have specific guidelines and reimbursement rates for this code. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. Providers should consult the relevant payer’s guidelines and policies to determine the coverage and reimbursement for this specific service.

8. Examples

Here are five examples of when HCPCS code G9820 should be billed:

1. A patient visits a primary care physician for a routine check-up. The physician performs a chlamydia screening test and documents the results. Based on the negative results, no further follow-up actions are required.
2. A gynecologist performs a chlamydia screening test during a well-woman exam. The test comes back positive, and the gynecologist provides appropriate treatment and documents the follow-up actions taken.
3. A patient visits an urgent care clinic with symptoms suggestive of a sexually transmitted infection. The healthcare provider performs a chlamydia screening test and documents the results. Based on the positive results, the provider refers the patient to a specialist for further evaluation and treatment.
4. A college health center offers free chlamydia screening tests to students. The tests are performed, and the results are documented. No further follow-up actions are required as all results are negative.
5. A patient receives a chlamydia screening test as part of a comprehensive sexual health check-up at a community health center. The results are documented, and based on the positive results, the patient is provided with appropriate treatment and counseling.