G9272 – Ldl value >= 100

Long description

Ldl value >= 100

Short description

Ldl 100 and over

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, 2015 – No change

Termination date

December 31, 2014

Nearby G codes

• G9264 – Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)
• G9265 – Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access
• G9266 – Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access
• G9267 – Documentation of patient with one or more complications or mortality within 30 days
• G9268 – Documentation of patient with one or more complications within 90 days
• G9269 – Documentation of patient without one or more complications and without mortality within 30 days
• G9270 – Documentation of patient without one or more complications within 90 days
• G9271 – Ldl value < 100
• G9273 – Blood pressure has a systolic value of < 140 and a diastolic value of < 90
• G9274 – Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
• G9275 – Documentation that patient is a current non-tobacco user
• G9276 – Documentation that patient is a current tobacco user
• G9277 – Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)
• G9278 – Documentation that the patient is not on daily aspirin or anti-platelet regimen
• G9279 – Pneumococcal screening performed and documentation of vaccination received prior to discharge
• G9280 – Pneumococcal vaccination not administered prior to discharge, reason not specified