Question 1

What is HCPCS code G9106?

Accepted Answer

HCPCS code G9106 is "Onc dx pancreatc p r1/r2 no". Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; post r1 or r2 resection with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)

Question 2

What category is G9106 in?

Accepted Answer

G9106 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9106?

Accepted Answer

Use G9106 when billing for onc dx pancreatc p r1/r2 no. 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 G9106 covered by Medicare?

Accepted Answer

Coverage for G9106 (Onc dx pancreatc p r1/r2 no) 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 G9106?

Accepted Answer

Documentation for G9106 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).