G9881 HCPCS - THE MDPP BENEFICIARY ACHIEVED AT LEAST 9% WEIGHT LOSS (WL) FROM HIS/HER BASELINE WEIGHT IN MONTHS 1-24 UNDER THE MDPP EXPANDED MODEL (EM). THIS IS A ONE-TIME PAYMENT AVAILABLE WHEN A BENEFICIARY FIRST ACHIEVES AT LEAST 9% WEIGHT LOSS FROM BASELINE AS MEASURED BY AN IN-PERSON WEIGHT MEASUREMENT AT A CORE SESSION, CORE MAINTENANCE SESSION, OR ONGOING MAINTENANCE SESSION

Code Information

HCPCS Code: G9881
Sequence Number: 0010
Short Description: Em 9 percent wl
Long Description: The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session
Date Added: 4/1/2018
Action Code: N - No maintenance for this code
Action Effective Date: 4/1/2018
Classification: Temporary Procedures & Professional Services
Coding System: HCPCS

Berenson-Eggers Type Of Service Code: Y1 - Other - Medicare fee schedule
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	G9881
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	The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session
HCPCS Short Description	Em 9 percent wl
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	Y1 - Other - Medicare fee schedule
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	4/1/2018
HCPCS Action Effective Date	4/1/2018
HCPCS Action Code	N - No maintenance for this code