Question 1

What is HCPCS code G2113?

Accepted Answer

HCPCS code G2113 is "Pred>5 mg >6m, no chg da". Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity

Question 2

What category is G2113 in?

Accepted Answer

G2113 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G2113?

Accepted Answer

Use G2113 when billing for pred>5 mg >6m, no chg da. 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 G2113 covered by Medicare?

Accepted Answer

Coverage for G2113 (Pred>5 mg >6m, no chg da) 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 G2113?

Accepted Answer

Documentation for G2113 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).