Question 1

What is HCPCS code G0101?

Accepted Answer

HCPCS code G0101 is "Ca screen;pelvic/breast exam". Cervical or vaginal cancer screening; pelvic and clinical breast examination

Question 2

What category is G0101 in?

Accepted Answer

G0101 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0101?

Accepted Answer

Use G0101 when billing for ca screen;pelvic/breast exam. 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 G0101 covered by Medicare?

Accepted Answer

Coverage for G0101 (Ca screen;pelvic/breast exam) 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 G0101?

Accepted Answer

Documentation for G0101 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).