Question 1

What is HCPCS code G0455?

Accepted Answer

HCPCS code G0455 is "Fecal microbiota prep instil". Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen

Question 2

What category is G0455 in?

Accepted Answer

G0455 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0455?

Accepted Answer

Use G0455 when billing for fecal microbiota prep instil. 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 G0455 covered by Medicare?

Accepted Answer

Coverage for G0455 (Fecal microbiota prep instil) 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 G0455?

Accepted Answer

Documentation for G0455 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).