Question 1

What is HCPCS code G9831?

Accepted Answer

HCPCS code G9831 is "Ajcc stg brt ca dx ii or iii". Ajcc stage at breast cancer diagnosis = ii or iii

Question 2

What category is G9831 in?

Accepted Answer

G9831 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9831?

Accepted Answer

Use G9831 when billing for ajcc stg brt ca dx ii or iii. 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 G9831 covered by Medicare?

Accepted Answer

Coverage for G9831 (Ajcc stg brt ca dx ii or iii) 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 G9831?

Accepted Answer

Documentation for G9831 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).