Question 1

What is HCPCS code G0500?

Accepted Answer

HCPCS code G0500 is "Mod sedat endo service >5yrs". Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)

Question 2

What category is G0500 in?

Accepted Answer

G0500 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0500?

Accepted Answer

Use G0500 when billing for mod sedat endo service >5yrs. 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 G0500 covered by Medicare?

Accepted Answer

Coverage for G0500 (Mod sedat endo service >5yrs) 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 G0500?

Accepted Answer

Documentation for G0500 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).