G9246 No enc or enc/vir ld 90days
Also known as: no viral load test 90 days, no HIV monitoring 90 days
No encounter or encounter without human immunodeficiency virus viral load test within 90 days.
In Plain Language
HIV patient not tested in 3 months
Clinical Context
Quality measure documenting inadequate human immunodeficiency virus monitoring with viral load testing not performed within recommended 90-day interval.
RVU Information
CPT G9246 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
G-codes are CMS-specific HCPCS codes for services not covered by standard CPT. Documentation requirements follow the same standards as the equivalent CPT service. Check Medicare LCD/NCD policies for coverage criteria.
How This Code Compares
This code has a work RVU of 0.00, meaning it does not have a physician work component assigned by CMS. In the G Codes category, 85% of codes share this characteristic.
Specialties
Frequently Asked Questions
What is CPT code G9246?
CPT G9246 (No enc or enc/vir ld 90days) is a G Codes code. No encounter or encounter without human immunodeficiency virus viral load test within 90 days.
Who uses CPT code G9246?
CPT G9246 is used by Infectious Disease, HIV Specialty, Internal Medicine. Quality measure documenting inadequate human immunodeficiency virus monitoring with viral load testing not performed within recommended 90-day interval.
When is CPT G9246 used?
Quality measure documenting inadequate human immunodeficiency virus monitoring with viral load testing not performed within recommended 90-day interval.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against national data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.