Question 1

What is HCPCS code G2155?

Accepted Answer

HCPCS code G2155 is "Hist contraindications". Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)

Question 2

What category is G2155 in?

Accepted Answer

G2155 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G2155?

Accepted Answer

Use G2155 when billing for hist contraindications. 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 G2155 covered by Medicare?

Accepted Answer

Coverage for G2155 (Hist contraindications) 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 G2155?

Accepted Answer

Documentation for G2155 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).