Summary & Overview
HCPCS G9748: Living Donor Kidney Transplant — Patient Approved and Scheduled
HCPCS Level II code G9748 denotes a patient who has been approved by a qualified transplant program and is scheduled to receive a living donor kidney transplant. This code captures a specific administrative and clinical milestone in the transplant pathway — approval and scheduling — which affects care coordination, operating room planning, and preoperative resource allocation. Nationally, clear coding for transplant scheduling supports accurate service tracking, program reporting, and claims processing across payers.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how G9748 is used in clinical workflows, the typical sites of service (hospital/transplant center), and the implications for billing and documentation. The publication highlights benchmarks for code usage where available, summarizes relevant policy or coverage considerations tied to transplant approval and scheduling, and provides clinical context on the role of the code in the transplant care continuum.
This piece is intended for clinicians, billing professionals, and policy analysts seeking a concise reference on G9748 — what it represents, who uses it, and what to expect in claims and reporting for living donor kidney transplant scheduling. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code G9748 indicates a patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant. The service type is transplant surgery coordination and scheduling for a living donor kidney transplant. The typical site of service is a hospital or transplant center where living donor kidney transplant procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with end-stage renal disease (ESRD) secondary to long-standing diabetes mellitus has been evaluated and approved by a qualified transplant program as a candidate for a living donor kidney transplant. The patient completed pre-transplant medical clearance, immunologic testing (HLA and crossmatch), infectious disease screening, psychosocial evaluation, and financial counseling. A living donor (usually a related or altruistic donor) completed donor evaluation and was accepted. The transplant surgery is scheduled at a transplant center with inpatient postoperative monitoring in a surgical intensive care or transplant unit.
The clinical workflow includes: preoperative evaluation and optimization by nephrology and transplant surgery, anesthesia assessment and consent, intraoperative living donor kidney implantation by the transplant surgical team, immediate postoperative care in a monitored inpatient setting with immunosuppression initiation by the transplant team and nephrology, and coordinated discharge planning with outpatient follow-up for medication management and graft surveillance. Billing for the pre-scheduled living donor kidney transplant episode is documented under the HCPCS Level II code G9748 to indicate patient approval by the transplant program and scheduling for the living donor kidney transplant.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |