How To Use HCPCS Code G9920

HCPCS code G9920 describes a screening procedure that is performed and yields a negative result. This code is used to identify instances where a screening test or examination is conducted, and the results indicate the absence of any abnormality or condition being screened for. It is important for medical coders to understand the specific details and guidelines associated with this code to ensure accurate billing and documentation.

1. What is HCPCS G9920?

HCPCS code G9920 is a specific code used in medical coding to represent a screening procedure that has been performed and has yielded a negative result. It is important to note that this code is only applicable for screening procedures and should not be used for diagnostic or treatment purposes. The purpose of this code is to indicate that a screening test or examination has been conducted, and the results indicate the absence of any abnormality or condition being screened for.

2. Official Description

The official description of HCPCS code G9920 is “Screening performed and negative.” The short description for this code is “Scrning perf and negative.” These descriptions accurately reflect the purpose and meaning of this specific code.

3. Procedure

1. The provider initiates the screening procedure based on the specific screening guidelines and protocols.
2. The necessary equipment and resources are prepared for the screening.
3. The patient is prepared for the screening procedure, which may involve providing instructions or obtaining consent.
4. The screening test or examination is performed according to the established protocols and guidelines.
5. The results of the screening are evaluated and documented.
6. If the screening results are negative, indicating the absence of any abnormality or condition being screened for, HCPCS code G9920 is assigned to accurately represent the performed screening and its negative outcome.

4. When to use HCPCS code G9920

HCPCS code G9920 should be used when a screening procedure has been performed, and the results indicate a negative outcome. It is important to ensure that the screening procedure aligns with the specific guidelines and protocols established for the particular screening being conducted. This code should not be used for diagnostic purposes or to represent any other type of medical service or procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9920, healthcare providers need to ensure that the documentation accurately reflects the screening procedure performed and the negative result obtained. The documentation should include details such as the specific screening test or examination conducted, the date of the screening, and any relevant patient information. It is important to follow the billing guidelines and requirements set forth by the relevant insurance providers to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9920 was added to the Healthcare Common Procedure Coding System on January 01, 2018. 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. This code is still currently active and can be used for appropriate billing and documentation purposes.

7. Medicare and Insurance Coverage

The coverage for HCPCS code G9920 may vary depending on the specific insurance provider. It is important to consult the Medicare guidelines or the individual insurance company’s policies to determine the coverage and reimbursement for this code. The pricing indicator code for this code 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. The multiple pricing indicator code is 9, which indicates that the value for this code is not established. It is important to verify the coverage and pricing with the relevant insurance provider before submitting a claim.

8. Examples

Here are five examples of when HCPCS code G9920 should be billed:

1. A patient undergoes a routine breast cancer screening mammogram, and the results indicate no abnormalities.
2. A patient receives a colonoscopy as part of a routine colorectal cancer screening, and the results show no signs of any abnormalities or polyps.
3. A patient undergoes a routine Pap smear for cervical cancer screening, and the results come back negative for any abnormal cells.
4. A patient undergoes a routine cholesterol screening test, and the results show normal cholesterol levels.
5. A patient receives a routine eye examination, including a glaucoma screening, and the results indicate no signs of glaucoma or other abnormalities.