Question 1

What is HCPCS code G0457?

Accepted Answer

HCPCS code G0457 is "Neg pres wound >50 sq cm". Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters

Question 2

What category is G0457 in?

Accepted Answer

G0457 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0457?

Accepted Answer

Use G0457 when billing for neg pres wound >50 sq cm. 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 G0457 covered by Medicare?

Accepted Answer

Coverage for G0457 (Neg pres wound >50 sq cm) 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 G0457?

Accepted Answer

Documentation for G0457 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).