Question 1

What is HCPCS code G0406?

Accepted Answer

HCPCS code G0406 is "Inpt/tele follow up 15". Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth

Question 2

What category is G0406 in?

Accepted Answer

G0406 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0406?

Accepted Answer

Use G0406 when billing for inpt/tele follow up 15. 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 G0406 covered by Medicare?

Accepted Answer

Coverage for G0406 (Inpt/tele follow up 15) 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 G0406?

Accepted Answer

Documentation for G0406 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).