Question 1

What is HCPCS code G0068?

Accepted Answer

HCPCS code G0068 is "Adm iv infusion drug in home". Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes

Question 2

What category is G0068 in?

Accepted Answer

G0068 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0068?

Accepted Answer

Use G0068 when billing for adm iv infusion drug in home. 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 G0068 covered by Medicare?

Accepted Answer

Coverage for G0068 (Adm iv infusion drug in home) 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 G0068?

Accepted Answer

Documentation for G0068 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).