HCPCS Code G9536

Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
Short DescriptionDoc med reas adv brain image
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2019
Code Added DateJanuary 01, 2016
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