Question 1

What is HCPCS code G8861?

Accepted Answer

HCPCS code G8861 is "Dxa ordered for osteo". Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed

Question 2

What category is G8861 in?

Accepted Answer

G8861 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8861?

Accepted Answer

Use G8861 when billing for dxa ordered for osteo. 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 G8861 covered by Medicare?

Accepted Answer

Coverage for G8861 (Dxa ordered for osteo) 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 G8861?

Accepted Answer

Documentation for G8861 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).