Question 1

What is HCPCS code G9065?

Accepted Answer

HCPCS code G9065 is "Onc dx nsclc stg3a no progre". Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)

Question 2

What category is G9065 in?

Accepted Answer

G9065 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9065?

Accepted Answer

Use G9065 when billing for onc dx nsclc stg3a no progre. 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 G9065 covered by Medicare?

Accepted Answer

Coverage for G9065 (Onc dx nsclc stg3a no progre) 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 G9065?

Accepted Answer

Documentation for G9065 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).