Question 1

What is HCPCS code G0249?

Accepted Answer

HCPCS code G0249 is "Provide inr test mater/equip". Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests

Question 2

What category is G0249 in?

Accepted Answer

G0249 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0249?

Accepted Answer

Use G0249 when billing for provide inr test mater/equip. 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 G0249 covered by Medicare?

Accepted Answer

Coverage for G0249 (Provide inr test mater/equip) 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 G0249?

Accepted Answer

Documentation for G0249 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).