Question 1

What is HCPCS code G0424?

Accepted Answer

HCPCS code G0424 is "Pulmonary rehab w exer". Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day

Question 2

What category is G0424 in?

Accepted Answer

G0424 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0424?

Accepted Answer

Use G0424 when billing for pulmonary rehab w 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

Is G0424 covered by Medicare?

Accepted Answer

Coverage for G0424 (Pulmonary rehab w 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 5

What documentation is required for G0424?

Accepted Answer

Documentation for G0424 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).