Question 1

What is HCPCS code G0468?

Accepted Answer

HCPCS code G0468 is "Fqhc visit, ippe or awv". Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv

Question 2

What category is G0468 in?

Accepted Answer

G0468 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0468?

Accepted Answer

Use G0468 when billing for fqhc visit, ippe or awv. 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 G0468 covered by Medicare?

Accepted Answer

Coverage for G0468 (Fqhc visit, ippe or awv) 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 G0468?

Accepted Answer

Documentation for G0468 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).