Question 1

What is HCPCS code G0458?

Accepted Answer

HCPCS code G0458 is "Ldr prostate brachy comp rat". Low dose rate (ldr) prostate brachytherapy services, composite rate

Question 2

What category is G0458 in?

Accepted Answer

G0458 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0458?

Accepted Answer

Use G0458 when billing for ldr prostate brachy comp rat. 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 G0458 covered by Medicare?

Accepted Answer

Coverage for G0458 (Ldr prostate brachy comp rat) 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 G0458?

Accepted Answer

Documentation for G0458 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).