HCPCS Code Details - G9218

HCPCS Level II Code
Procedures/Professional Services (Temporary Codes)
HCPCS Code G9218

Long description:
Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given

Short description:
No pcp prop low at cd4 norsn

HCPCS Modifier1
HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
BETOS2 code M5B - Specialist - psychiatry
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2015
Date added Added Jan 01, 2014
Termination date Dec 31, 2014
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS G9216 · Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given

  • HCPCS G9217 · Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given

  • HCPCS G9219 · Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 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)

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”