Field Name |
Field Value |
Healthcare Common Procedure Coding System Code |
G9220 |
HCPCS Sequence Number |
0010 |
HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
HCPCS Long Description |
Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
HCPCS Short Description |
No order for pjp for medrsn |
HCPCS Pricing Indicator Code 1 |
00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) |
HCPCS Multiple Pricing Indicator Code |
9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') |
HCPCS Coverage Code |
C - Carrier judgment |
HCPCS Berenson-Eggers Type Of Service Code |
M5B - Specialist - psychiatry |
HCPCS Type Of Service Code 1 |
1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96 |
HCPCS Anesthesia Base Unit Quantity |
0 |
HCPCS Code Added Date |
1/1/2014 |
HCPCS Action Effective Date |
1/1/2015 |
HCPCS Termination Date |
12/31/2014 |
HCPCS Action Code |
N - No maintenance for this code |