Question 1

What is HCPCS code G9585?

Accepted Answer

HCPCS code G9585 is "No eval opi use instr/intv". Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy

Question 2

What category is G9585 in?

Accepted Answer

G9585 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9585?

Accepted Answer

Use G9585 when billing for no eval opi use instr/intv. 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 G9585 covered by Medicare?

Accepted Answer

Coverage for G9585 (No eval opi use instr/intv) 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 G9585?

Accepted Answer

Documentation for G9585 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).