Summary & Overview
HCPCS G9455: Abdominal Imaging for Hepatocellular Carcinoma Evaluation
HCPCS Level II code G9455 denotes abdominal imaging performed using ultrasound, contrast-enhanced CT, or contrast MRI specifically for evaluation of hepatocellular carcinoma (HCC). Nationally, this code captures a targeted set of diagnostic imaging services used in detection, characterization, and surveillance of liver malignancy, and it is relevant to radiology, oncology, and hepatology care pathways.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for HCC-directed abdominal imaging, typical sites of service, and the scope of services this code represents. The publication provides benchmarks and coverage context where available, clarifies common billing modifiers used with advanced imaging, and outlines implications for service-line reporting in radiology and oncology.
This summary is intended for health system administrators, coding and billing professionals, and clinical leaders who need a national perspective on how G9455 is used to document abdominal imaging for HCC evaluation. Data not available in the input will be explicitly noted in the detailed sections that follow.
Billing Code Overview
HCPCS Level II code G9455 represents imaging of the abdomen performed to evaluate hepatocellular carcinoma (HCC) using ultrasound, contrast-enhanced CT, or contrast MRI. This code describes a diagnostic imaging service focused on detection, characterization, or surveillance of suspected or known HCC.
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Service type: Abdominal oncologic diagnostic imaging (ultrasound, contrast-enhanced CT, or contrast MRI)
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Typical site of service: Outpatient radiology departments, hospital imaging centers, and freestanding outpatient imaging facilities
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of chronic hepatitis C and cirrhosis is referred for evaluation of a newly detected 2.5 cm hepatic lesion on surveillance ultrasound. The hepatology team orders contrast-enhanced imaging to characterize the lesion for hepatocellular carcinoma (HCC). The imaging modality selected is either a multiphasic contrast-enhanced CT of the abdomen, contrast-enhanced MRI of the liver, or targeted diagnostic abdominal ultrasound with contrast per facility capability and patient contraindications.
The clinical workflow begins with scheduling and preauthorization as needed, assessment for contrast allergy and renal function, and informed consent. On the day of service, the patient presents to the radiology department or outpatient imaging center. Nursing performs IV access and administers contrast per protocol if CT or MRI is selected. The technologist acquires multiphasic arterial, portal venous, and delayed phase images for CT or dynamic contrast-enhanced sequences for MRI. The radiologist interprets the images using LI-RADS and documents lesion size, enhancement pattern, and ancillary features. The report is communicated to the referring hepatologist for management decisions, which may include biopsy, locoregional therapy, or continued surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the work required is substantially greater than typically required for this service due to clinical complexity. |