Question 1

What is HCPCS code S0126?

Accepted Answer

HCPCS code S0126 is "Inj follitropin alfa 75 iu". Injection, follitropin alfa, 75 iu

Question 2

What category is S0126 in?

Accepted Answer

S0126 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S0126?

Accepted Answer

Use S0126 when billing for inj follitropin alfa 75 iu. 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 S0126 covered by Medicare?

Accepted Answer

Coverage for S0126 (Inj follitropin alfa 75 iu) 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 S0126?

Accepted Answer

Documentation for S0126 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).