Question 1

What is HCPCS code G9101?

Accepted Answer

HCPCS code G9101 is "Onc dx gastric p r1-r2noprog". Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r1 or r2 resection (with or without neoadjuvant therapy) with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)

Question 2

What category is G9101 in?

Accepted Answer

G9101 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9101?

Accepted Answer

Use G9101 when billing for onc dx gastric p r1-r2noprog. 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 G9101 covered by Medicare?

Accepted Answer

Coverage for G9101 (Onc dx gastric p r1-r2noprog) 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 G9101?

Accepted Answer

Documentation for G9101 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).