Question 1

What is HCPCS code G0514?

Accepted Answer

HCPCS code G0514 is "Prolong prev svcs, addl 30m". Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)

Question 2

What category is G0514 in?

Accepted Answer

G0514 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0514?

Accepted Answer

Use G0514 when billing for prolong prev svcs, addl 30m. 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 G0514 covered by Medicare?

Accepted Answer

Coverage for G0514 (Prolong prev svcs, addl 30m) 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 G0514?

Accepted Answer

Documentation for G0514 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).