Question 1

What is HCPCS code G0562?

Accepted Answer

HCPCS code G0562 is "Complex simulation w/pet-ct". Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)

Question 2

What category is G0562 in?

Accepted Answer

G0562 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0562?

Accepted Answer

Use G0562 when billing for complex simulation w/pet-ct. 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 G0562 covered by Medicare?

Accepted Answer

Coverage for G0562 (Complex simulation w/pet-ct) 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 G0562?

Accepted Answer

Documentation for G0562 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).