Question 1

What is HCPCS code G0919?

Accepted Answer

HCPCS code G0919 is "Flu immunize not avail". Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit

Question 2

What category is G0919 in?

Accepted Answer

G0919 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0919?

Accepted Answer

Use G0919 when billing for flu immunize not avail. 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 G0919 covered by Medicare?

Accepted Answer

Coverage for G0919 (Flu immunize not avail) 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 G0919?

Accepted Answer

Documentation for G0919 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).