Question 1

What is HCPCS code G9304?

Accepted Answer

HCPCS code G9304 is "Pros info op rpt". Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant

Question 2

What category is G9304 in?

Accepted Answer

G9304 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9304?

Accepted Answer

Use G9304 when billing for pros info op rpt. 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 G9304 covered by Medicare?

Accepted Answer

Coverage for G9304 (Pros info op rpt) 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 G9304?

Accepted Answer

Documentation for G9304 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).