G9659 HCPCS - PATIENTS GREATER THAN 85 YEARS OF AGE WHO DID NOT HAVE A HISTORY OF COLORECTAL CANCER OR VALID MEDICAL REASON FOR THE COLONOSCOPY, INCLUDING: IRON DEFICIENCY ANEMIA, LOWER GASTROINTESTINAL BLEEDING, CROHN'S DISEASE (I.E., REGIONAL ENTERITIS), FAMILIAL ADENOMATOUS POLYPOSIS, LYNCH SYNDROME (I.E., HEREDITARY NON-POLYPOSIS COLORECTAL CANCER), INFLAMMATORY BOWEL DISEASE, ULCERATIVE COLITIS, ABNORMAL FINDING OF GASTROINTESTINAL TRACT, OR CHANGES IN BOWEL HABITS

Code Information

HCPCS Code: G9659

Sequence Number: 0010

Short Description: >85y no hx colo ca/rsn scope

Long Description: Patients greater than 85 years of age who did not have a history of colorectal cancer or valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits

Code Added Date: 1/1/2016

Action Code: N - No maintenance for this code

Action Effective Date: 1/1/2016

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 G9659
      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 Patients greater than 85 years of age who did not have a history of colorectal cancer or valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits
      HCPCS Short Description >85y no hx colo ca/rsn scope
      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 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 1/1/2016
      HCPCS Action Effective Date 1/1/2016
      HCPCS Action Code N - No maintenance for this code

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