2025 HCPCS Code G0559

Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)

TAGS: separately professional transfer questions complications physically visit arisen examine addition progressing formal available possible research procedure period unique circumstances determine surgical global complexity outside evaluate anatomy there expected could whether reading group different practitioner within specialty qualified relative required management
Short DescriptionUnrelat prac follow up visit
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2025
HCPCS Action Effective Date January 01, 2025
HCPCS Pricing Indicator Code 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
HCPCS Type Of Service Code 1 - Medical care
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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