Question 1

What is HCPCS code G0499?

Accepted Answer

HCPCS code G0499 is "Hepb screen high risk indiv". Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result

Question 2

What category is G0499 in?

Accepted Answer

G0499 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0499?

Accepted Answer

Use G0499 when billing for hepb screen high risk indiv. 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 G0499 covered by Medicare?

Accepted Answer

Coverage for G0499 (Hepb screen high risk indiv) 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 G0499?

Accepted Answer

Documentation for G0499 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).