HCPCS Code G9246

Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

Procedures/Professional Services (Temporary Codes)

G9246 is a valid 2026 HCPCS code for Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart or just “No enc or enc/vir ld 90days” for short, used in Medical care.

HCPCS Code Details - G9246

HCPCS Level II Code
Procedures/Professional Services (Temporary Codes)
HCPCS Code G9246
Description

Long description:
Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

Short description:
No enc or enc/vir ld 90days

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, 2025
Date added Added Jan 01, 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 G9245 · Antiretroviral therapy prescribed

  • HCPCS G2156 · Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)

  • HCPCS G2159 · Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period

  • HCPCS G2162 · Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period

  • HCPCS G2165 · Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period

  • HCPCS G2202 · Patient did not receive brief counseling if identified as an unhealthy alcohol user

  • HCPCS G2208 · Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy

  • HCPCS G9248 · Patient did not have a medical visit in the last 6 months

  • HCPCS G9377 · Patient did not have the retina attached after 6 months following only one surgery

  • HCPCS G9379 · Patient did not achieve flat retinas six months post surgery

  • HCPCS G9404 · Patient did not receive follow-up within 30 days after discharge

  • HCPCS G9407 · Patient did not receive follow-up within 7 days after discharge

  • HCPCS G9415 · Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y or a, c, w, y, b), on or between the patient's 10th and 13th birthdays

  • HCPCS G9417 · Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays

  • HCPCS G9457 · Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period

  • HCPCS G9499 · Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period

  • HCPCS G9247 · Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

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”