| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
G0365 |
| 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 |
Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow) |
| HCPCS Short Description |
Vessel mapping hemo access |
| HCPCS Pricing Indicator Code 1 |
11 - Price established using national rvu's |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS ASC Payment Group Code |
YY |
| HCPCS ASC Payment Group Effective Date |
1/1/2012 |
| HCPCS Berenson-Eggers Type Of Service Code |
P9A - Dialysis services (medicare fee schedule) |
| HCPCS Type Of Service Code 1 |
5 - Diagnostic laboratory |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2005 |
| HCPCS Action Effective Date |
1/1/2005 |
| HCPCS Action Code |
N - No maintenance for this code |