Question 1

What is HCPCS code G0437?

Accepted Answer

HCPCS code G0437 is "Tobacco-use counsel>10min". Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes

Question 2

What category is G0437 in?

Accepted Answer

G0437 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0437?

Accepted Answer

Use G0437 when billing for tobacco-use counsel>10min. 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 G0437 covered by Medicare?

Accepted Answer

Coverage for G0437 (Tobacco-use counsel>10min) 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 G0437?

Accepted Answer

Documentation for G0437 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).