Q: What category is G9667 in?

G9667 belongs to HCPCS Category G (Procedures/Professional Services).

Q: When should I use HCPCS code G9667?

Use G9667 when billing for doc med rsn no stat tx/presc. 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.

Q: Is G9667 covered by Medicare?

Coverage for G9667 (Doc med rsn no stat tx/presc) 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.

Q: What documentation is required for G9667?

Documentation for G9667 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).

Question 1

What is HCPCS code G9667?

Accepted Answer

HCPCS code G9667 is "Doc med rsn no stat tx/presc". Documentation of medical reason(s) for not currently being a statin   therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)

Question 2

What category is G9667 in?

Accepted Answer

G9667 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9667?

Accepted Answer

Use G9667 when billing for doc med rsn no stat tx/presc. 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 G9667 covered by Medicare?

Accepted Answer

Coverage for G9667 (Doc med rsn no stat tx/presc) 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 G9667?

Accepted Answer

Documentation for G9667 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).