Question 1

What is HCPCS code G0454?

Accepted Answer

HCPCS code G0454 is "Md document visit by npp". Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist

Question 2

What category is G0454 in?

Accepted Answer

G0454 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0454?

Accepted Answer

Use G0454 when billing for md document visit by npp. 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 G0454 covered by Medicare?

Accepted Answer

Coverage for G0454 (Md document visit by npp) 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 G0454?

Accepted Answer

Documentation for G0454 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).