Summary & Overview
HCPCS G9299: Preoperative VTE and Cardiovascular Risk Not Evaluated
HCPCS Level II code G9299 documents that a patient did not receive a venous thromboembolic (VTE) and cardiovascular risk evaluation within 30 days prior to a procedure. This administrative code flags missing pre-procedural risk assessment for conditions such as deep vein thrombosis, pulmonary embolism, myocardial infarction, arrhythmia, and stroke, and it is used in clinical documentation and billing to identify gaps in preoperative safety processes. Nationally, such codes matter because pre-procedure risk assessment is central to preventing perioperative thrombotic and cardiac complications and to quality-measure reporting.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what G9299 represents, its clinical context in preoperative care, and typical sites of service where the code is relevant. The publication outlines common billing modifiers and ancillary administrative details provided in the input, and it highlights the implications of an absent risk evaluation for coding, documentation, and quality monitoring. The content is designed to help billing managers, compliance officers, and clinical leaders understand the purpose of G9299, where it is likely to appear in claims, and what information is not available in the input (for example, specific ICD-10 pairings or payer-specific policies).
Billing Code Overview
HCPCS Level II code G9299 indicates that a patient was not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure. The description cites examples such as history of deep vein thrombosis (dvt), pulmonary embolism (pe), myocardial infarction (mi), arrhythmia, and stroke, with reason not given.
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Service type: Pre-procedure cardiovascular and venous thromboembolism risk evaluation (not performed)
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Typical site of service: Preoperative or procedural evaluation setting, including outpatient surgical centers and hospital preoperative clinics
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old scheduled for an elective outpatient urologic procedure under general anesthesia. Preoperative nursing intake and the surgeon’s clinic note do not document assessment of venous thromboembolism (VTE) history (prior deep vein thrombosis or pulmonary embolism) or cardiovascular events (myocardial infarction, arrhythmia, stroke) within 30 days before the procedure. The anesthesiologist is preparing the perioperative plan and the facility’s preoperative screening checklist lacks documentation of recent VTE or acute cardiac events. The workflow includes preoperative phone screening, in‑person pre-op nursing assessment, and anesthesia preoperative evaluation; however, no clinician documents the required 30‑day cardiovascular/VTE risk review, and the reason for omission is not recorded. This scenario triggers reporting of the HCPCS Level II code G9299 to indicate the absence of evaluation for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When additional work beyond typical service is documented (rarely applicable to G9299) |