Question 1

What is HCPCS code G0130?

Accepted Answer

HCPCS code G0130 is "Single energy x-ray study". Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)

Question 2

What category is G0130 in?

Accepted Answer

G0130 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0130?

Accepted Answer

Use G0130 when billing for single energy x-ray study. 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

What ICD-10 codes are commonly used with G0130?

Accepted Answer

Common ICD-10 diagnosis codes used with G0130 include: E21.0 (Primary hyperparathyroidism), E21.3 (Hyperparathyroidism, unspecified), E23.0 (Hypopituitarism), E24.0 (Pituitary-dependent Cushing's disease). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0130 covered by Medicare?

Accepted Answer

Coverage for G0130 (Single energy x-ray study) 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 6

What documentation is required for G0130?

Accepted Answer

Documentation for G0130 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).