Question 1

What is HCPCS code G8128?

Accepted Answer

HCPCS code G8128 is "Pt inelig for antidepres med". Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure

Question 2

What category is G8128 in?

Accepted Answer

G8128 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8128?

Accepted Answer

Use G8128 when billing for pt inelig for antidepres med. 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 G8128 covered by Medicare?

Accepted Answer

Coverage for G8128 (Pt inelig for antidepres med) 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 G8128?

Accepted Answer

Documentation for G8128 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).