G2159 HCPCS - 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

Code Information

HCPCS Code: G2159
Sequence Number: 0010
Short Description: No pneum vacc 12 mo 60+
Long Description: 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
Date Added: 1/1/2020
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2021
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	G2159
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	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 Short Description	No pneum vacc 12 mo 60+
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	1/1/2021
HCPCS Termination Date	12/31/2020
HCPCS Action Code	N - No maintenance for this code