Question 1

What is HCPCS code G9195?

Accepted Answer

HCPCS code G9195 is "Mdd pt not treated for 180d". Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase

Question 2

What category is G9195 in?

Accepted Answer

G9195 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9195?

Accepted Answer

Use G9195 when billing for mdd pt not treated for 180d. 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 G9195 covered by Medicare?

Accepted Answer

Coverage for G9195 (Mdd pt not treated for 180d) 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 G9195?

Accepted Answer

Documentation for G9195 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).