Question 1

What is HCPCS code G9156?

Accepted Answer

HCPCS code G9156 is "Evaluation for wheelchair". Evaluation for wheelchair requiring face to face visit with physician

Question 2

What category is G9156 in?

Accepted Answer

G9156 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9156?

Accepted Answer

Use G9156 when billing for evaluation for wheelchair. 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 G9156 covered by Medicare?

Accepted Answer

Coverage for G9156 (Evaluation for wheelchair) 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 G9156?

Accepted Answer

Documentation for G9156 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).