Question 1

What is HCPCS code G9504?

Accepted Answer

HCPCS code G9504 is "Doc rsn hep b stat not asses". Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy

Question 2

What category is G9504 in?

Accepted Answer

G9504 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9504?

Accepted Answer

Use G9504 when billing for doc rsn hep b stat not asses. 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 G9504 covered by Medicare?

Accepted Answer

Coverage for G9504 (Doc rsn hep b stat not asses) 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 G9504?

Accepted Answer

Documentation for G9504 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).