Question 1

What is HCPCS code G0296?

Accepted Answer

HCPCS code G0296 is "Visit to determ ldct elig". Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)

Question 2

What category is G0296 in?

Accepted Answer

G0296 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0296?

Accepted Answer

Use G0296 when billing for visit to determ ldct elig. 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 G0296 covered by Medicare?

Accepted Answer

Coverage for G0296 (Visit to determ ldct elig) 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 G0296?

Accepted Answer

Documentation for G0296 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).