G9247 – Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

Long description

Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

Short description

2 enc enc/vir ld 90d

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, 2025 – No change

Nearby G codes

• G9239 – Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)
• G9240 – Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated
• G9241 – Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated
• G9242 – Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed
• G9243 – Documentation of viral load less than 200 copies/ml
• G9244 – Antiretroviral thereapy not prescribed
• G9245 – Antiretroviral therapy prescribed
• G9246 – Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart
• G9248 – Patient did not have a medical visit in the last 6 months
• G9249 – Patient had a medical visit in the last 6 months
• G9250 – Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment
• G9251 – Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment
• G9252 – Adenoma(s) or other neoplasm detected during screening colonoscopy
• G9253 – Adenoma(s) or other neoplasm not detected during screening colonoscopy
• G9254 – Documentation of patient discharged to home later than post-operative day 2 following cea or cas
• G9255 – Documentation of patient discharged to home no later than post operative day 2 following cea or cas