Question 1

What is HCPCS code G0921?

Accepted Answer

HCPCS code G0921 is "Doc pt reas no assess". Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)

Question 2

What category is G0921 in?

Accepted Answer

G0921 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0921?

Accepted Answer

Use G0921 when billing for doc pt reas no assess. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0921 covered by Medicare?

Accepted Answer

Coverage for G0921 (Doc pt reas no assess) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0921?

Accepted Answer

Documentation for G0921 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).