Question 1

What is HCPCS code G9138?

Accepted Answer

HCPCS code G9138 is "Onc dx nhl stg unknown". Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)

Question 2

What category is G9138 in?

Accepted Answer

G9138 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9138?

Accepted Answer

Use G9138 when billing for onc dx nhl stg unknown. 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 G9138 covered by Medicare?

Accepted Answer

Coverage for G9138 (Onc dx nhl stg unknown) 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 G9138?

Accepted Answer

Documentation for G9138 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).