Question 1

What is HCPCS code G0545?

Accepted Answer

HCPCS code G0545 is "Inherent visit to inpt". Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge)

Question 2

What category is G0545 in?

Accepted Answer

G0545 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0545?

Accepted Answer

Use G0545 when billing for inherent visit to inpt. 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 G0545 covered by Medicare?

Accepted Answer

Coverage for G0545 (Inherent visit to inpt) 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 G0545?

Accepted Answer

Documentation for G0545 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).