Question 1

What is HCPCS code G1028?

Accepted Answer

HCPCS code G1028 is "Take home supply 8mg per 0.1". Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

Question 2

What category is G1028 in?

Accepted Answer

G1028 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G1028?

Accepted Answer

Use G1028 when billing for take home supply 8mg per 0.1. 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

What ICD-10 codes are commonly used with G1028?

Accepted Answer

Common ICD-10 diagnosis codes used with G1028 include: F11.10 (Opioid abuse, uncomplicated), F11.11 (Opioid abuse, in remission), F11.120 (Opioid abuse with intoxication, uncomplicated), F11.121 (Opioid abuse with intoxication delirium). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G1028 covered by Medicare?

Accepted Answer

Coverage for G1028 (Take home supply 8mg per 0.1) 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 6

What documentation is required for G1028?

Accepted Answer

Documentation for G1028 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).