G9938 – Patients aged 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period

Long description

Patients aged 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period

Short description

Pt 66+ snp or ltc pos > 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, 2018

Last change

January 1, 2024 – No change

Nearby G codes

• G9930 – Patients who are receiving comfort care only
• G9931 – Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women
• G9932 – Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)
• G9933 – Adenoma(s) or colorectal cancer detected during screening colonoscopy
• G9934 – Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
• G9935 – Adenoma(s) or colorectal cancer not detected during screening colonoscopy
• G9936 – Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
• G9937 – Diagnostic colonoscopy
• G9939 – Pathologists/dermatopathologists is the same clinician who performed the biopsy
• G9940 – Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)
• G9941 – Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
• G9942 – Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
• G9943 – Back pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
• G9944 – Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
• G9945 – Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
• G9946 – Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively