Question 1

What is HCPCS code G0561?

Accepted Answer

HCPCS code G0561 is "Temp tube delivery, unil". Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)

Question 2

What category is G0561 in?

Accepted Answer

G0561 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0561?

Accepted Answer

Use G0561 when billing for temp tube delivery, unil. 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 G0561 covered by Medicare?

Accepted Answer

Coverage for G0561 (Temp tube delivery, unil) 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 G0561?

Accepted Answer

Documentation for G0561 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).