Question 1

What is HCPCS code G9395?

Accepted Answer

HCPCS code G9395 is "Ini phq9 >9 no remiss >=5". Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five

Question 2

What category is G9395 in?

Accepted Answer

G9395 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9395?

Accepted Answer

Use G9395 when billing for ini phq9 >9 no remiss >=5. 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 G9395 covered by Medicare?

Accepted Answer

Coverage for G9395 (Ini phq9 >9 no remiss >=5) 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 G9395?

Accepted Answer

Documentation for G9395 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).