Question 1

What is HCPCS code G9369?

Accepted Answer

HCPCS code G9369 is "Fill 2 rx antipsych". Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater

Question 2

What category is G9369 in?

Accepted Answer

G9369 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9369?

Accepted Answer

Use G9369 when billing for fill 2 rx antipsych. 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 G9369 covered by Medicare?

Accepted Answer

Coverage for G9369 (Fill 2 rx antipsych) 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 G9369?

Accepted Answer

Documentation for G9369 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).