Question 1

What is HCPCS code G0176?

Accepted Answer

HCPCS code G0176 is "Opps/php/iop; activity thrpy". Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)

Question 2

What category is G0176 in?

Accepted Answer

G0176 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0176?

Accepted Answer

Use G0176 when billing for opps/php/iop; activity thrpy. 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 G0176?

Accepted Answer

Common ICD-10 diagnosis codes used with G0176 include: F01.50 (Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F01.511 (Vascular dementia, unspecified severity, with agitation), F01.518 (Vascular dementia, unspecified severity, with other behavioral disturbance), F01.52 (Vascular dementia, unspecified severity, with psychotic disturbance). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0176 covered by Medicare?

Accepted Answer

Coverage for G0176 (Opps/php/iop; activity thrpy) 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 G0176?

Accepted Answer

Documentation for G0176 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).