Question 1

What is HCPCS code G0279?

Accepted Answer

HCPCS code G0279 is "Tomosynthesis, mammo". Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Question 2

What category is G0279 in?

Accepted Answer

G0279 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0279?

Accepted Answer

Use G0279 when billing for tomosynthesis, mammo. 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 G0279?

Accepted Answer

Common ICD-10 diagnosis codes used with G0279 include: C45.9 (Mesothelioma, unspecified), C50.011 (Malignant neoplasm of nipple and areola, right female breast), C50.012 (Malignant neoplasm of nipple and areola, left female breast), C50.021 (Malignant neoplasm of nipple and areola, right male breast). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0279 covered by Medicare?

Accepted Answer

Coverage for G0279 (Tomosynthesis, mammo) 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 G0279?

Accepted Answer

Documentation for G0279 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).