Q: What category is G0313 in?

G0313 belongs to HCPCS Category G (Procedures/Professional Services).

Q: When should I use HCPCS code G0313?

Use G0313 when billing for immunize couns < 21yr 6-30 m. 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.

Q: Is G0313 covered by Medicare?

Coverage for G0313 (Immunize couns < 21yr 6-30 m) 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.

Q: What documentation is required for G0313?

Documentation for G0313 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).

Question 1

What is HCPCS code G0313?

Accepted Answer

HCPCS code G0313 is "Immunize couns < 21yr 6-30 m". Immunization counseling by a physician or other qualified health care professional when  the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)

Question 2

What category is G0313 in?

Accepted Answer

G0313 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0313?

Accepted Answer

Use G0313 when billing for immunize couns < 21yr 6-30 m. 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 G0313 covered by Medicare?

Accepted Answer

Coverage for G0313 (Immunize couns < 21yr 6-30 m) 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 G0313?

Accepted Answer

Documentation for G0313 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).