2025 HCPCS Code 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)

TAGS: patients mental funduscopic patient neurological young advanced recent neurologic imaging abnormal study pulsations pressure signs altered documentation brain increased meningeal intracranial ordering absent severe venous immunocompromised headache medical focal onset coexistence unexplained
NoticeHCPCS G9536 terminated on December 31, 2018.
Short DescriptionDoc med reas adv brain image
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2016
HCPCS Action Effective Date January 01, 2019
HCPCS Pricing Indicator Code 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Type Of Service Code 1 - Medical care
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 Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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