2025 HCPCS Code G9220
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)
TAGS: count reason acceptable medical prescribed months below jiroveci prophylaxis within pneumocystis require threshold pneumonia range levels patient indicating percentage above| Notice | HCPCS G9220 terminated on December 31, 2014. |
| Short Description | No order for pjp for medrsn |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Code Added Date | January 01, 2014 |
| HCPCS Action Effective Date | January 01, 2015 |
| 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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