How To Use HCPCS Code G9948

HCPCS code G9948 describes the additional spine procedures performed on the same date as the lumbar discectomy/laminectomy. This code is used to indicate that the patient underwent other spinal procedures in addition to the primary procedure on the same day. In this article, we will explore the details of HCPCS code G9948, 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 G9948?

HCPCS code G9948 is used to identify additional spine procedures performed on the same date as the lumbar discectomy/laminectomy. It is important to note that this code should only be used when there are other spinal procedures performed in addition to the primary procedure on the same day.

2. Official Description

The official description of HCPCS code G9948 is “Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy.” The short description for this code is “Adtl spine proc on same date.”

3. Procedure

1. Before using HCPCS code G9948, it is essential to ensure that the patient has undergone a lumbar discectomy/laminectomy procedure on the same date.
2. Identify any additional spine procedures that were performed on the same day as the primary procedure.
3. Assign HCPCS code G9948 to indicate the presence of these additional spine procedures.

4. When to use HCPCS code G9948

HCPCS code G9948 should be used when the patient has undergone a lumbar discectomy/laminectomy procedure and additional spine procedures were performed on the same date. It is important to note that this code should only be used when there are other spinal procedures performed in addition to the primary procedure on the same day.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9948, healthcare providers need to document the lumbar discectomy/laminectomy procedure and clearly indicate the additional spine procedures performed on the same date. It is crucial to provide detailed documentation to support the medical necessity of these additional procedures.

6. Historical Information and Code Maintenance

HCPCS code G9948 was added to the Healthcare Common Procedure Coding System on January 01, 2018. It has an effective date of January 01, 2023. As of December 31, 2022, this code is terminated and no longer in use. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9948 may vary. It is important to check with the specific payer to determine if this code is payable. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as the code is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G9948 should be billed:

1. A patient undergoes a lumbar discectomy/laminectomy and also receives a spinal fusion procedure on the same date.
2. A patient undergoes a lumbar discectomy/laminectomy and also receives a laminotomy procedure on the same date.
3. A patient undergoes a lumbar discectomy/laminectomy and also receives a vertebroplasty procedure on the same date.
4. A patient undergoes a lumbar discectomy/laminectomy and also receives a kyphoplasty procedure on the same date.
5. A patient undergoes a lumbar discectomy/laminectomy and also receives a spinal decompression procedure on the same date.