Question 1

What is HCPCS code G0559?

Accepted Answer

HCPCS code G0559 is "Unrelat prac follow up visit". Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable:    reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation.    research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty).    evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately.    communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)

Question 2

What category is G0559 in?

Accepted Answer

G0559 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0559?

Accepted Answer

Use G0559 when billing for unrelat prac follow up visit. 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 G0559 covered by Medicare?

Accepted Answer

Coverage for G0559 (Unrelat prac follow up visit) 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 G0559?

Accepted Answer

Documentation for G0559 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).