Question 1

What is HCPCS code S0260?

Accepted Answer

HCPCS code S0260 is "H&p for surgery". History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)

Question 2

What category is S0260 in?

Accepted Answer

S0260 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S0260?

Accepted Answer

Use S0260 when billing for h&p for surgery. 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 S0260 covered by Medicare?

Accepted Answer

Coverage for S0260 (H&p for surgery) 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 S0260?

Accepted Answer

Documentation for S0260 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).