Question 1

What is HCPCS code G9354?

Accepted Answer

HCPCS code G9354 is "1 or no ct sinus w/in 90d dx". One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis

Question 2

What category is G9354 in?

Accepted Answer

G9354 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9354?

Accepted Answer

Use G9354 when billing for 1 or no ct sinus w/in 90d dx. 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 G9354 covered by Medicare?

Accepted Answer

Coverage for G9354 (1 or no ct sinus w/in 90d dx) 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 G9354?

Accepted Answer

Documentation for G9354 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).