Question 1

What is HCPCS code S0315?

Accepted Answer

HCPCS code S0315 is "Disease management program". Disease management program; initial assessment and initiation of the program

Question 2

What category is S0315 in?

Accepted Answer

S0315 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S0315?

Accepted Answer

Use S0315 when billing for disease management program. 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 S0315 covered by Medicare?

Accepted Answer

Coverage for S0315 (Disease management program) 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 S0315?

Accepted Answer

Documentation for S0315 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).