Question 1

What is HCPCS code G0412?

Accepted Answer

HCPCS code G0412 is "Open tx iliac spine uni/bil". Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed

Question 2

What category is G0412 in?

Accepted Answer

G0412 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0412?

Accepted Answer

Use G0412 when billing for open tx iliac spine uni/bil. 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 G0412 covered by Medicare?

Accepted Answer

Coverage for G0412 (Open tx iliac spine uni/bil) 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 G0412?

Accepted Answer

Documentation for G0412 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).