Question 1

What is HCPCS code G0414?

Accepted Answer

HCPCS code G0414 is "Pelvic ring fx treat int fix". Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)

Question 2

What category is G0414 in?

Accepted Answer

G0414 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0414?

Accepted Answer

Use G0414 when billing for pelvic ring fx treat int fix. 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 G0414 covered by Medicare?

Accepted Answer

Coverage for G0414 (Pelvic ring fx treat int fix) 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 G0414?

Accepted Answer

Documentation for G0414 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).