Question 1

What is HCPCS code G0421?

Accepted Answer

HCPCS code G0421 is "Ed svc ckd grp per session". Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour

Question 2

What category is G0421 in?

Accepted Answer

G0421 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0421?

Accepted Answer

Use G0421 when billing for ed svc ckd grp per session. 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 G0421 covered by Medicare?

Accepted Answer

Coverage for G0421 (Ed svc ckd grp per session) 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 G0421?

Accepted Answer

Documentation for G0421 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).