G2097 HCPCS - EPISODES WHERE THE PATIENT HAD A COMPETING DIAGNOSIS ON OR WITHIN THREE DAYS AFTER THE EPISODE DATE (E.G., INTESTINAL INFECTION, PERTUSSIS, BACTERIAL INFECTION, LYME DISEASE, OTITIS MEDIA, ACUTE SINUSITIS, CHRONIC SINUSITIS, INFECTION OF THE ADENOIDS, PROSTATITIS, CELLULITIS, MASTOIDITIS, OR BONE INFECTIONS, ACUTE LYMPHADENITIS, IMPETIGO, SKIN STAPH INFECTIONS, PNEUMONIA/GONOCOCCAL INFECTIONS, VENEREAL DISEASE (SYPHILIS, CHLAMYDIA, INFLAMMATORY DISEASES [FEMALE REPRODUCTIVE ORGANS]), INFECTIONS OF THE KIDNEY, CYSTITIS OR UTI)

Code Information

HCPCS Code: G2097
Sequence Number: 0010
Short Description: Dx uri 3d after other dx
Long Description: Episodes where the patient had a competing diagnosis on or within three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, chronic sinusitis, infection of the adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti)
Date Added: 1/1/2020
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2022
Classification: Temporary Procedures & Professional Services
Coding System: HCPCS

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

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

Field Name	Field Value
Healthcare Common Procedure Coding System Code	G2097
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	Episodes where the patient had a competing diagnosis on or within three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, chronic sinusitis, infection of the adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti)
HCPCS Short Description	Dx uri 3d after other dx
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	1/1/2020
HCPCS Action Effective Date	1/1/2022
HCPCS Action Code	N - No maintenance for this code