Question 1

What is HCPCS code G0260?

Accepted Answer

HCPCS code G0260 is "Inj for sacroiliac jt anesth". Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

Question 2

What category is G0260 in?

Accepted Answer

G0260 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0260?

Accepted Answer

Use G0260 when billing for inj for sacroiliac jt anesth. 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 G0260?

Accepted Answer

Common ICD-10 diagnosis codes used with G0260 include: M43.28 (Fusion of spine, sacral and sacrococcygeal region), M46.1 (Sacroiliitis, not elsewhere classified), M47.818 (Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region), M53.3 (Sacrococcygeal disorders, not elsewhere classified). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0260 covered by Medicare?

Accepted Answer

Coverage for G0260 (Inj for sacroiliac jt anesth) 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 G0260?

Accepted Answer

Documentation for G0260 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).