Question 1

What is HCPCS code G9071?

Accepted Answer

HCPCS code G9071 is "Onc dx brst stg1-2b hr,nopro". Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)

Question 2

What category is G9071 in?

Accepted Answer

G9071 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9071?

Accepted Answer

Use G9071 when billing for onc dx brst stg1-2b hr,nopro. 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 G9071 covered by Medicare?

Accepted Answer

Coverage for G9071 (Onc dx brst stg1-2b hr,nopro) 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 G9071?

Accepted Answer

Documentation for G9071 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).