2024 HCPCS Code G9220

Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

Notice	HCPCS G9220 terminated on December 31, 2014.
Short Description	No order for pjp for medrsn
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2015
HCPCS Code Added Date	January 01, 2014
HCPCS Pricing Indicator Code	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 Issues Manual Reference Section Number
HCPCS Type Of Service Code	1 - Medical care
HCPCS Anesthesia Base Unit Quantity	0