Question 1

What is HCPCS code G0418?

Accepted Answer

HCPCS code G0418 is "Sat biopsy prostate 41-60". Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens

Question 2

What category is G0418 in?

Accepted Answer

G0418 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0418?

Accepted Answer

Use G0418 when billing for sat biopsy prostate 41-60. 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 G0418 covered by Medicare?

Accepted Answer

Coverage for G0418 (Sat biopsy prostate 41-60) 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 G0418?

Accepted Answer

Documentation for G0418 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).