Question 1

What is HCPCS code G8846?

Accepted Answer

HCPCS code G8846 is "Mod or severe osa". Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)

Question 2

What category is G8846 in?

Accepted Answer

G8846 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8846?

Accepted Answer

Use G8846 when billing for mod or severe osa. 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 G8846 covered by Medicare?

Accepted Answer

Coverage for G8846 (Mod or severe osa) 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 G8846?

Accepted Answer

Documentation for G8846 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).