Question 1

What is HCPCS code G9277?

Accepted Answer

HCPCS code G9277 is "Doc daily aspirin or contra". Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)

Question 2

What category is G9277 in?

Accepted Answer

G9277 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9277?

Accepted Answer

Use G9277 when billing for doc daily aspirin or contra. 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 G9277 covered by Medicare?

Accepted Answer

Coverage for G9277 (Doc daily aspirin or contra) 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 G9277?

Accepted Answer

Documentation for G9277 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).