Question 1

What is HCPCS code G9666?

Accepted Answer

HCPCS code G9666 is "Fas/dir ldl 70-189mg/dl mst". Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl

Question 2

What category is G9666 in?

Accepted Answer

G9666 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9666?

Accepted Answer

Use G9666 when billing for fas/dir ldl 70-189mg/dl mst. 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 G9666 covered by Medicare?

Accepted Answer

Coverage for G9666 (Fas/dir ldl 70-189mg/dl mst) 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 G9666?

Accepted Answer

Documentation for G9666 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).