Question 1

What is HCPCS code G0423?

Accepted Answer

HCPCS code G0423 is "Intens cardiac rehab no exer". Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session

Question 2

What category is G0423 in?

Accepted Answer

G0423 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0423?

Accepted Answer

Use G0423 when billing for intens cardiac rehab no exer. 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 G0423?

Accepted Answer

Common ICD-10 diagnosis codes used with G0423 include: I20.1 (Angina pectoris with documented spasm), I20.2 (Refractory angina pectoris), I20.81 (Angina pectoris with coronary microvascular dysfunction), I20.89 (Other forms of angina pectoris). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0423 covered by Medicare?

Accepted Answer

Coverage for G0423 (Intens cardiac rehab no exer) 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 G0423?

Accepted Answer

Documentation for G0423 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).