Question 1

What is HCPCS code G0460?

Accepted Answer

HCPCS code G0460 is "Autolog prp not diab ulcer". Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment

Question 2

What category is G0460 in?

Accepted Answer

G0460 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0460?

Accepted Answer

Use G0460 when billing for autolog prp not diab ulcer. 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 G0460 covered by Medicare?

Accepted Answer

Coverage for G0460 (Autolog prp not diab ulcer) 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 G0460?

Accepted Answer

Documentation for G0460 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).