Question 1

What is HCPCS code G2074?

Accepted Answer

HCPCS code G2074 is "Med assist tx no drug". Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)

Question 2

What category is G2074 in?

Accepted Answer

G2074 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G2074?

Accepted Answer

Use G2074 when billing for med assist tx no drug. 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 G2074?

Accepted Answer

Common ICD-10 diagnosis codes used with G2074 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 G2074 covered by Medicare?

Accepted Answer

Coverage for G2074 (Med assist tx no drug) 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 G2074?

Accepted Answer

Documentation for G2074 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).