G9520 – Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

Long description

Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

Short description

Refract not +/- 1.0 w/in 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

Z2 Undefined codes

Added

January 1, 2016

Last change

January 1, 2020 – No change

Nearby G codes

• G9512 – Individual had a pdc of 0.8 or greater
• G9513 – Individual did not have 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
• G9521 – Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
• G9522 – Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
• G9523 – Patient discontinued from hemodialysis or peritoneal dialysis
• G9524 – Patient was referred to hospice care
• G9525 – Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
• G9526 – Patient was not referred to hospice care, reason not given
• G9529 – Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
• G9530 – Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider