Question 1

What is HCPCS code G9087?

Accepted Answer

HCPCS code G9087 is "Onc dx colon metas evid dx". Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)

Question 2

What category is G9087 in?

Accepted Answer

G9087 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9087?

Accepted Answer

Use G9087 when billing for onc dx colon metas evid dx. 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 G9087 covered by Medicare?

Accepted Answer

Coverage for G9087 (Onc dx colon metas evid dx) 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 G9087?

Accepted Answer

Documentation for G9087 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).