Question 1

What is HCPCS code G9555?

Accepted Answer

HCPCS code G9555 is "Doc med rsn for follup image". Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))

Question 2

What category is G9555 in?

Accepted Answer

G9555 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9555?

Accepted Answer

Use G9555 when billing for doc med rsn for follup image. 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 G9555 covered by Medicare?

Accepted Answer

Coverage for G9555 (Doc med rsn for follup image) 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 G9555?

Accepted Answer

Documentation for G9555 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).