Question 1

What is HCPCS code G0513?

Accepted Answer

HCPCS code G0513 is "Prolong prev svcs, first 30m". Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)

Question 2

What category is G0513 in?

Accepted Answer

G0513 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0513?

Accepted Answer

Use G0513 when billing for prolong prev svcs, first 30m. 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 G0513 covered by Medicare?

Accepted Answer

Coverage for G0513 (Prolong prev svcs, first 30m) 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 G0513?

Accepted Answer

Documentation for G0513 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).