Question 1

What is HCPCS code G9547?

Accepted Answer

HCPCS code G9547 is "Cys ren les or adren". Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion  less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols

Question 2

What category is G9547 in?

Accepted Answer

G9547 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9547?

Accepted Answer

Use G9547 when billing for cys ren les or adren. 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 G9547 covered by Medicare?

Accepted Answer

Coverage for G9547 (Cys ren les or adren) 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 G9547?

Accepted Answer

Documentation for G9547 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).