Question 1

What is HCPCS code G9698?

Accepted Answer

HCPCS code G9698 is "Sys rsn no presc bronchdil". Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., cost of treatment or lack of insurance)

Question 2

What category is G9698 in?

Accepted Answer

G9698 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9698?

Accepted Answer

Use G9698 when billing for sys 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 G9698 covered by Medicare?

Accepted Answer

Coverage for G9698 (Sys 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 G9698?

Accepted Answer

Documentation for G9698 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).