Question 1

What is HCPCS code S0265?

Accepted Answer

HCPCS code S0265 is "Genetic counsel 15 mins". Genetic counseling, under physician supervision, each 15 minutes

Question 2

What category is S0265 in?

Accepted Answer

S0265 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S0265?

Accepted Answer

Use S0265 when billing for genetic counsel 15 mins. 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 S0265 covered by Medicare?

Accepted Answer

Coverage for S0265 (Genetic counsel 15 mins) 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 S0265?

Accepted Answer

Documentation for S0265 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).