Question 1

What is HCPCS code G8946?

Accepted Answer

HCPCS code G8946 is "Mibm but no dx of breast ca". Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)

Question 2

What category is G8946 in?

Accepted Answer

G8946 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8946?

Accepted Answer

Use G8946 when billing for mibm but no dx of breast ca. 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 G8946 covered by Medicare?

Accepted Answer

Coverage for G8946 (Mibm but no dx of breast ca) 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 G8946?

Accepted Answer

Documentation for G8946 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).