G9486 HCPCS - REMOTE IN-HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT FOR USE ONLY IN THE MEDICARE-APPROVED COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL, WHICH REQUIRES AT LEAST 2 OF THE FOLLOWING 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINATION; STRAIGHTFORWARD MEDICAL DECISION MAKING, FURNISHED IN REAL TIME USING INTERACTIVE AUDIO AND VIDEO TECHNOLOGY. COUNSELING AND COORDINATION OF CARE WITH OTHER PHYSICIANS, OTHER QUALIFIED HEALTH CARE PROFESSIONALS OR AGENCIES ARE PROVIDED CONSISTENT WITH THE NATURE OF THE PROBLEM(S) AND THE NEEDS OF THE PATIENT OR THE FAMILY OR BOTH. USUALLY, THE PRESENTING PROBLEM(S) ARE SELF LIMITED OR MINOR. TYPICALLY, 10 MINUTES ARE SPENT WITH THE PATIENT OR FAMILY OR BOTH VIA REAL TIME, AUDIO AND VIDEO INTERCOMMUNICATIONS TECHNOLOGY

Code Information

HCPCS Code: G9486

Sequence Number: 0010

Short Description: Remote e/m est. pt 10mins

Long Description: Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

Code Added Date: 4/1/2016

Action Code: N - No maintenance for this code

Action Effective Date: 4/1/2016

Classification: Temporary Procedures & Professional Services

Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: Z2 - Undefined codes
Type Of Service Code:
  • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

Pricing Indicator Code:
  • 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
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')
Coverage Issues Manual Reference Section Number:
    N/A
    Medicare Carriers Manual Reference Section Number:
      N/A
      Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G9486
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
      HCPCS Short Description Remote e/m est. pt 10mins
      HCPCS Pricing Indicator Code 1 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
      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 Coverage Code C - Carrier judgment
      HCPCS Processing Note Number 0206
      HCPCS Berenson-Eggers Type Of Service Code Z2 - Undefined codes
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 4/1/2016
      HCPCS Action Effective Date 4/1/2016
      HCPCS Action Code N - No maintenance for this code

      Download Record

      Download this HCPCS record in Text format: Export

      Download this HCPCS record in Excel (CSV) format: Export

      Download this HCPCS record in XML format: Export

      This page was last updated on: 1/1/2018