Question 1

What is HCPCS code G0035?

Accepted Answer

HCPCS code G0035 is "Pt ed pos 23". Patient has any emergency department encounter during the performance period with place of service indicator 23

Question 2

What category is G0035 in?

Accepted Answer

G0035 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0035?

Accepted Answer

Use G0035 when billing for pt ed pos 23. 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 G0035 covered by Medicare?

Accepted Answer

Coverage for G0035 (Pt ed pos 23) 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 G0035?

Accepted Answer

Documentation for G0035 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).