Question 1

What is HCPCS code G0403?

Accepted Answer

HCPCS code G0403 is "Ekg for initial prevent exam". Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report

Question 2

What category is G0403 in?

Accepted Answer

G0403 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0403?

Accepted Answer

Use G0403 when billing for ekg for initial prevent exam. 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 G0403 covered by Medicare?

Accepted Answer

Coverage for G0403 (Ekg for initial prevent exam) 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 G0403?

Accepted Answer

Documentation for G0403 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).