Question 1

What is HCPCS code G2086?

Accepted Answer

HCPCS code G2086 is "Off base opioid tx 70min". Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month

Question 2

What category is G2086 in?

Accepted Answer

G2086 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G2086?

Accepted Answer

Use G2086 when billing for off base opioid tx 70min. 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 G2086 covered by Medicare?

Accepted Answer

Coverage for G2086 (Off base opioid tx 70min) 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 G2086?

Accepted Answer

Documentation for G2086 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).