Question 1

What is HCPCS code G0498?

Accepted Answer

HCPCS code G0498 is "Chemo extend iv infus w/pump". Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion

Question 2

What category is G0498 in?

Accepted Answer

G0498 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0498?

Accepted Answer

Use G0498 when billing for chemo extend iv infus w/pump. 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 G0498 covered by Medicare?

Accepted Answer

Coverage for G0498 (Chemo extend iv infus w/pump) 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 G0498?

Accepted Answer

Documentation for G0498 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).