Question 1

What is HCPCS code G0551?

Accepted Answer

HCPCS code G0551 is "Phn/intr svs fr dx treat 30m". Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes

Question 2

What category is G0551 in?

Accepted Answer

G0551 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0551?

Accepted Answer

Use G0551 when billing for phn/intr svs fr dx treat 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 G0551 covered by Medicare?

Accepted Answer

Coverage for G0551 (Phn/intr svs fr dx treat 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 G0551?

Accepted Answer

Documentation for G0551 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).