Summary & Overview
HCPCS G9544: Follow-up/Reassessment for Implanted Filter Not Removed
HCPCS Level II code G9544 documents post-placement follow-up when an implanted filter has not been removed. The code captures clinical reassessment of the appropriateness of filter removal or at least two documented attempts to contact the patient to arrange such reassessment within three months of placement. Nationally, this code matters because it standardizes documentation for follow-up care and supports clinical quality tracking and billing consistency for outpatient and ambulatory follow-up services tied to vascular filter management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for use and coverage patterns, summaries of relevant policy language, and clinical context explaining when G9544 applies. The publication outlines common modifiers and payer-specific considerations where available, highlights documentation elements required to support the code, and notes areas where input data are not available. The focus is national policy and billing practice implications rather than state-level rules or clinical recommendations.
Billing Code Overview
HCPCS Level II code G9544 covers documentation related to implanted filters when the filter has not been removed. Specifically, it represents cases where the record shows that the patient did not have the filter removed, a documented re-assessment of the appropriateness of filter removal was performed, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for filter removal within three months of placement.
Service type: Clinical follow-up and reassessment regarding implanted filter removal.
Typical site of service: Outpatient clinic or ambulatory care setting where post-procedure follow-up and documentation occur. If additional settings apply, Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with recent traumatic pelvic fractures and immobilization underwent placement of a retrievable inferior vena cava (IVC) filter during hospitalization for high risk of venous thromboembolism. Three months after placement, the vascular surgery clinic documents that the filter remains in place. The clinical workflow includes an outpatient re-assessment visit to evaluate ongoing need for the filter, review of anticoagulation status and contraindications, imaging review (abdominal radiograph or CT venography as indicated), and documentation of plans for removal if clinically appropriate. If the patient cannot be reached to schedule the re-assessment, staff document at least two separate attempts (telephone calls, secure patient portal messages, certified letters) within the 3-month window. The service represented by billing code G9544 captures cases where the filter was not removed and where either a documented re-assessment for appropriateness of removal occurred or at least two documented outreach attempts to arrange that re-assessment were made within three months of placement. Typical site of service is outpatient vascular surgery or interventional radiology clinic, or post-discharge care coordination performed by the hospital or clinic care management team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to manage filter follow-up (complex re-assessment or extensive documentation) substantially exceeds typical expectations. |