Question 1

What is HCPCS code G9549?

Accepted Answer

HCPCS code G9549 is "Doc med rsn for f/u imag". Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))

Question 2

What category is G9549 in?

Accepted Answer

G9549 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9549?

Accepted Answer

Use G9549 when billing for doc med rsn for f/u imag. 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 G9549 covered by Medicare?

Accepted Answer

Coverage for G9549 (Doc med rsn for f/u imag) 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 G9549?

Accepted Answer

Documentation for G9549 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).