G9537 – Imaging needed as part of a clinical trial; or other clinician ordered the study

Long description

Imaging needed as part of a clinical trial; or other clinician ordered the study

Short description

Img hd clin trial

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, 2021 – No change

Nearby G codes

• 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
• 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
• 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)
• G9538 – Advanced brain imaging (cta, ct, mra or mri) was ordered
• G9539 – Intent for potential removal at time of placement
• G9540 – Patient alive 3 months post procedure
• G9541 – Filter removed within 3 months of placement
• G9542 – Documented re-assessment for the appropriateness of filter removal within 3 months of placement
• G9543 – Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
• G9544 – Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
• G9547 – Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols