Question 1

What is HCPCS code G9278?

Accepted Answer

HCPCS code G9278 is "Doc no daily aspirin". Documentation that the patient is not on daily aspirin or anti-platelet regimen

Question 2

What category is G9278 in?

Accepted Answer

G9278 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9278?

Accepted Answer

Use G9278 when billing for doc no daily aspirin. 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 G9278 covered by Medicare?

Accepted Answer

Coverage for G9278 (Doc no daily aspirin) 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 G9278?

Accepted Answer

Documentation for G9278 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).