Question 1

What is HCPCS code G9696?

Accepted Answer

HCPCS code G9696 is "Med rsn no presc bronchdil". Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects)

Question 2

What category is G9696 in?

Accepted Answer

G9696 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9696?

Accepted Answer

Use G9696 when billing for med rsn no presc bronchdil. 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 G9696 covered by Medicare?

Accepted Answer

Coverage for G9696 (Med rsn no presc bronchdil) 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 G9696?

Accepted Answer

Documentation for G9696 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).