Question 1

What is HCPCS code G0109?

Accepted Answer

HCPCS code G0109 is "Diab manage trn ind/group". Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes

Question 2

What category is G0109 in?

Accepted Answer

G0109 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0109?

Accepted Answer

Use G0109 when billing for diab manage trn ind/group. 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 G0109 covered by Medicare?

Accepted Answer

Coverage for G0109 (Diab manage trn ind/group) 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 G0109?

Accepted Answer

Documentation for G0109 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).