Question 1

What is HCPCS code G0160?

Accepted Answer

HCPCS code G0160 is "Hhc occup therapy ea 15". Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes

Question 2

What category is G0160 in?

Accepted Answer

G0160 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0160?

Accepted Answer

Use G0160 when billing for hhc occup therapy ea 15. 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 G0160?

Accepted Answer

Common ICD-10 diagnosis codes used with G0160 include: A18.01 (Tuberculosis of spine), A18.02 (Tuberculous arthritis of other joints), A52.16 (Charcôt's arthropathy (tabetic)), B91 (Sequelae of poliomyelitis). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0160 covered by Medicare?

Accepted Answer

Coverage for G0160 (Hhc occup therapy ea 15) 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 G0160?

Accepted Answer

Documentation for G0160 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).