Question 1

What is HCPCS code G9115?

Accepted Answer

HCPCS code G9115 is "Onc dx ovarian stg3/4 noprog". Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage iii-iv; without evidence of progression, recurrence, or metastases (for use in a medicare-approved demonstration project)

Question 2

What category is G9115 in?

Accepted Answer

G9115 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9115?

Accepted Answer

Use G9115 when billing for onc dx ovarian stg3/4 noprog. 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 G9115 covered by Medicare?

Accepted Answer

Coverage for G9115 (Onc dx ovarian stg3/4 noprog) 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 G9115?

Accepted Answer

Documentation for G9115 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).