HCPCS Code G9196

Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))
Short DescriptionMed reason for no ceph
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2023
Code Added DateJanuary 01, 2014
Pricing Indicator00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)
Type of Service1 = Medical care