G9227 – Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter

Long description

Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter

Short description

Foa doc, care plan not doc

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, 2018 – No change

Nearby G codes

• G9219 – Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)
• G9220 – Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)
• G9221 – Pneumocystis jiroveci pneumonia prophlaxis prescribed
• G9222 – Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
• G9223 – Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%
• G9224 – Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)
• G9225 – Foot exam was not performed, reason not given
• G9226 – Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)
• G9228 – Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)
• G9229 – Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)
• G9230 – Chlamydia, gonorrhea, and syphilis not screened, reason not given
• G9231 – Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period
• G9232 – Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)
• G9233 – All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
• G9234 – I intend to report the total knee replacement measures group
• G9235 – All quality actions for the applicable measures in the general surgery measures group have been performed for this patient