Question 1

What is HCPCS code G9467?

Accepted Answer

HCPCS code G9467 is "Recd cortico >=10mg/day >60d". Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months

Question 2

What category is G9467 in?

Accepted Answer

G9467 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9467?

Accepted Answer

Use G9467 when billing for recd cortico >=10mg/day >60d. 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 G9467 covered by Medicare?

Accepted Answer

Coverage for G9467 (Recd cortico >=10mg/day >60d) 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 G9467?

Accepted Answer

Documentation for G9467 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).