Question 1

What is HCPCS code G0411?

Accepted Answer

HCPCS code G0411 is "Interactive grp psyc php/iop". Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes

Question 2

What category is G0411 in?

Accepted Answer

G0411 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0411?

Accepted Answer

Use G0411 when billing for interactive grp psyc php/iop. 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 G0411?

Accepted Answer

Common ICD-10 diagnosis codes used with G0411 include: E66.01 (Morbid (severe) obesity due to excess calories), F01.50 (Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F01.511 (Vascular dementia, unspecified severity, with agitation), F01.518 (Vascular dementia, unspecified severity, with other behavioral disturbance). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0411 covered by Medicare?

Accepted Answer

Coverage for G0411 (Interactive grp psyc php/iop) 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 G0411?

Accepted Answer

Documentation for G0411 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).