G9531 – Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar

Long description

Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar

Short description

Pt 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

Z2 Undefined codes

Added

January 1, 2016

Last change

January 1, 2020 – No change

Nearby G codes

• 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
• G9532 – Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
• G9533 – Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
• G9534 – Advanced brain imaging (cta, ct, mra or mri) was not ordered
• G9535 – Patients with a normal neurological examination
• G9536 – Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
• G9537 – Imaging needed as part of a clinical trial; or other clinician ordered the study
• G9538 – Advanced brain imaging (cta, ct, mra or mri) was ordered
• G9539 – Intent for potential removal at time of placement