G9196 – Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))

Long description

Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))

Short description

Med reason for no ceph

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

M5B Specialist - psychiatry

Added

January 1, 2014

Last change

January 1, 2023 – No change

Termination date

December 31, 2022

Nearby G codes

• G9188 – Beta-blocker therapy not prescribed, reason not given
• G9189 – Beta-blocker therapy prescribed or currently being taken
• G9190 – Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)
• G9191 – Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)
• G9192 – Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)
• G9193 – Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression
• G9194 – Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase
• G9195 – Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase
• G9197 – Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis
• G9198 – Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given
• G9199 – Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))
• G9200 – Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
• G9201 – Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
• G9202 – Patients with a positive hepatitis c antibody test
• G9203 – Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
• G9204 – Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given