Question 1

What is HCPCS code G0490?

Accepted Answer

HCPCS code G0490 is "Home visit rn, lpn by rhc/fq". Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies;  (services limited to rn or lpn only)

Question 2

What category is G0490 in?

Accepted Answer

G0490 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0490?

Accepted Answer

Use G0490 when billing for home visit rn, lpn by rhc/fq. 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 G0490 covered by Medicare?

Accepted Answer

Coverage for G0490 (Home visit rn, lpn by rhc/fq) 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 G0490?

Accepted Answer

Documentation for G0490 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).