Question 1

What is HCPCS code G9828?

Accepted Answer

HCPCS code G9828 is "Her-2 targ ther dur init tx". Her2-targeted therapies administered during the initial course of treatment

Question 2

What category is G9828 in?

Accepted Answer

G9828 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9828?

Accepted Answer

Use G9828 when billing for her-2 targ ther dur init tx. 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 G9828 covered by Medicare?

Accepted Answer

Coverage for G9828 (Her-2 targ ther dur init tx) 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 G9828?

Accepted Answer

Documentation for G9828 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).