Question 1

What is HCPCS code G0166?

Accepted Answer

HCPCS code G0166 is "Extrnl counterpulse, per tx". External counterpulsation, per treatment session

Question 2

What category is G0166 in?

Accepted Answer

G0166 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0166?

Accepted Answer

Use G0166 when billing for extrnl counterpulse, per tx. 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 G0166 covered by Medicare?

Accepted Answer

Coverage for G0166 (Extrnl counterpulse, per tx) 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 G0166?

Accepted Answer

Documentation for G0166 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).