Question 1

What is HCPCS code G8873?

Accepted Answer

HCPCS code G8873 is "Specimen not intraop image". Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)

Question 2

What category is G8873 in?

Accepted Answer

G8873 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8873?

Accepted Answer

Use G8873 when billing for specimen not intraop image. 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 G8873 covered by Medicare?

Accepted Answer

Coverage for G8873 (Specimen not intraop image) 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 G8873?

Accepted Answer

Documentation for G8873 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).