Summary & Overview
HCPCS G9711: Total Colectomy or Colorectal Cancer History
HCPCS Level II code G9711 denotes patients with a diagnosis or past history of total colectomy or colorectal cancer. The code is used in clinical documentation and claims to flag patients who require ongoing postoperative surveillance, cancer follow-up, or care coordination related to their colorectal surgical history. Nationally, accurate use of this code supports appropriate clinical follow-up and can inform population-level monitoring of colorectal cancer survivorship and surgical outcomes.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical context, typical sites of service, common billing modifiers, and payer considerations where available. The publication summarizes benchmarks and policy-relevant points that affect billing and documentation for patients with prior total colectomy or colorectal cancer, and it highlights where input data were not provided.
This report provides operational clarity for coding teams, billing managers, and clinical leaders seeking to align claims with clinical records and payer requirements. It outlines what clinicians and coders need to know about the code's purpose, expected settings of use, and the payer landscape that commonly reimburses services linked to this patient population.
Billing Code Overview
HCPCS Level II code G9711 identifies patients with a diagnosis or past history of total colectomy or colorectal cancer. This code is used to indicate clinical status related to significant colorectal surgical history or cancer diagnosis.
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Service type: Postoperative and cancer survivorship classification, including care coordination and surveillance-related services
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Typical site of service: Ambulatory surgical centers, hospital outpatient departments, colorectal surgery clinics, oncology clinics, and other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of ulcerative colitis underwent a total colectomy two years ago and now presents for routine long-term surveillance and management related to prior colorectal cancer risk and surgical history. The patient is evaluated in an outpatient colorectal surgery clinic and may require periodic visits with a colorectal surgeon or gastroenterologist, ostomy care nursing, and coordination with oncology if prior cancer treatment occurred. Typical workflow: initial outpatient visit includes history of present illness focused on bowel function, stoma assessment if present, review of pathology and prior operative report, medication and adjuvant therapy reconciliation, and screening for complications such as parastomal hernia, small bowel obstruction, or recurrent malignancy. Diagnostic steps may include targeted physical exam, abdominal and pelvic imaging (CT or MRI), laboratory studies including carcinoembryonic antigen (CEA) when prior colorectal cancer exists, and referrals to enterostomal therapy nurses. Procedures that may occur during the encounter include stoma revision planning, counseling on surveillance intervals, or scheduling of endoscopic or imaging surveillance. Typical sites of service are outpatient clinics, ambulatory surgery centers for minor revisions, or hospital-based clinics when coordination with oncology or complex reconstruction is required. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |