Question 1

What is HCPCS code G9911?

Accepted Answer

HCPCS code G9911 is "Node neg pre/post syst ther". Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant  systemic therapy

Question 2

What category is G9911 in?

Accepted Answer

G9911 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9911?

Accepted Answer

Use G9911 when billing for node neg pre/post syst ther. 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 G9911 covered by Medicare?

Accepted Answer

Coverage for G9911 (Node neg pre/post syst ther) 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 G9911?

Accepted Answer

Documentation for G9911 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).