Question 1

What is HCPCS code G0409?

Accepted Answer

HCPCS code G0409 is "Corf related serv 15 mins ea". Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)

Question 2

What category is G0409 in?

Accepted Answer

G0409 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0409?

Accepted Answer

Use G0409 when billing for corf related serv 15 mins ea. 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 G0409?

Accepted Answer

Common ICD-10 diagnosis codes used with G0409 include: F01.A0 (Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F01.A11 (Vascular dementia, mild, with agitation), F01.A18 (Vascular dementia, mild, with other behavioral disturbance), F01.A2 (Vascular dementia, mild, with psychotic disturbance). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0409 covered by Medicare?

Accepted Answer

Coverage for G0409 (Corf related serv 15 mins ea) 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 G0409?

Accepted Answer

Documentation for G0409 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).