Question 1

What is HCPCS code G9660?

Accepted Answer

HCPCS code G9660 is "Doc med rsn colo pt >= 86y". Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits)

Question 2

What category is G9660 in?

Accepted Answer

G9660 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9660?

Accepted Answer

Use G9660 when billing for doc med rsn colo pt >= 86y. 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 G9660 covered by Medicare?

Accepted Answer

Coverage for G9660 (Doc med rsn colo pt >= 86y) 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 G9660?

Accepted Answer

Documentation for G9660 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).