Question 1

What is HCPCS code G9650?

Accepted Answer

HCPCS code G9650 is "Doc pt no ther chg or contra". Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi

Question 2

What category is G9650 in?

Accepted Answer

G9650 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9650?

Accepted Answer

Use G9650 when billing for doc pt no ther chg or contra. 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 G9650 covered by Medicare?

Accepted Answer

Coverage for G9650 (Doc pt no ther chg or contra) 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 G9650?

Accepted Answer

Documentation for G9650 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).