Question 1

What is HCPCS code G0427?

Accepted Answer

HCPCS code G0427 is "Inpt/ed teleconsult70". Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth

Question 2

What category is G0427 in?

Accepted Answer

G0427 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0427?

Accepted Answer

Use G0427 when billing for inpt/ed teleconsult70. 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 G0427 covered by Medicare?

Accepted Answer

Coverage for G0427 (Inpt/ed teleconsult70) 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 G0427?

Accepted Answer

Documentation for G0427 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).