How To Use HCPCS Code G9955

HCPCS code G9955 describes cases in which an inhalational anesthetic is used only for induction. This code is used to identify specific situations where the inhalational anesthetic is administered solely for the purpose of inducing anesthesia, without any maintenance or continuation of the anesthesia throughout the procedure. It is important for medical coders to understand the meaning and usage of this code in order to accurately report and bill for these services.

1. What is HCPCS G9955?

HCPCS code G9955 is a specific code used to identify cases where an inhalational anesthetic is used only for induction. It is important to note that this code is not used for cases where the inhalational anesthetic is used for both induction and maintenance of anesthesia. The purpose of this code is to accurately capture and document the specific use of inhalational anesthetics in medical procedures.

2. Official Description

The official description of HCPCS code G9955 is “Cases in which an inhalational anesthetic is used only for induction.” The short description for this code is “Inhlnt anesth only for induc.” These descriptions provide a clear and concise understanding of the purpose and usage of this code.

3. Procedure

1. The provider begins by assessing the patient’s medical history, current health status, and any potential risks or contraindications for anesthesia.
2. Once the patient is deemed suitable for anesthesia, the provider administers the inhalational anesthetic agent.
3. The inhalational anesthetic is carefully monitored to ensure the patient reaches the desired level of anesthesia for induction.
4. After the induction phase is complete, the provider may proceed with the medical procedure or surgery.
5. It is important to note that this code does not cover the maintenance or continuation of anesthesia throughout the procedure.

4. When to use HCPCS code G9955

HCPCS code G9955 should be used in cases where the inhalational anesthetic is administered solely for the purpose of induction. It is important to accurately document and report this specific use of anesthesia to ensure proper coding and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9955, healthcare providers should ensure that the documentation clearly indicates that the inhalational anesthetic was used only for induction. This may include details such as the type and dosage of the anesthetic agent used, the duration of the induction phase, and any relevant patient information. Proper documentation is essential for accurate coding and billing.

6. Historical Information and Code Maintenance

HCPCS code G9955 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. It is important for medical coders to stay updated on any changes or revisions to the code in order to ensure accurate reporting and billing.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G9955 may vary. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers. 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 or other insurers. The multiple pricing indicator code is 9, which indicates that the value for this code is not established. Providers should consult the appropriate fee schedules and guidelines for accurate pricing and reimbursement information.

8. Examples

Here are five examples of when HCPCS code G9955 should be billed:

1. A patient undergoes a surgical procedure where the inhalational anesthetic is administered solely for induction and not for maintenance.
2. An anesthesiologist administers an inhalational anesthetic to a patient in preparation for a medical procedure, but no further anesthesia is required during the procedure.
3. A patient receives an inhalational anesthetic for the induction phase of a dental procedure, but no additional anesthesia is needed during the treatment.
4. An anesthetic is used only for induction during a diagnostic procedure that requires the patient to be in a state of anesthesia.
5. A patient undergoes a minor surgical procedure where the inhalational anesthetic is used solely for induction and no maintenance is required.