G9513 – Individual did not have a pdc of 0.8 or greater

Long description

Individual did not have a pdc of 0.8 or greater

Short description

Indiv pdc not > 0.8

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

Z2 Undefined codes

Added

January 1, 2016

Last change

January 1, 2016 – No change

Nearby G codes

• G9505 – Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
• G9506 – Biologic immune response modifier prescribed
• G9507 – Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
• G9508 – Documentation that the patient is not on a statin medication
• G9509 – Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
• G9510 – Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5
• G9511 – Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
• G9512 – Individual had a pdc of 0.8 or greater
• G9514 – Patient required a return to the operating room within 90 days of surgery
• G9515 – Patient did not require a return to the operating room within 90 days of surgery
• G9516 – Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
• G9517 – Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
• G9518 – Documentation of active injection drug use
• G9519 – Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
• G9520 – Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
• G9521 – Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months