What is the purpose of G-codes in HCPCS?

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G-codes in HCPCS (Healthcare Common Procedure Coding System) are a specific subset of Level II HCPCS codes used primarily by Medicare to report procedures, services, and interventions not covered by CPT codes or when Medicare needs more detailed tracking for reimbursement or policy purposes.

Purpose of G-codes:

1. Medicare-specific services:
   G-codes are often used to describe services unique to Medicare, including preventive care, screenings, and telehealth services.

2. Temporary or supplemental codes:
   They are sometimes used temporarily for services awaiting CPT approval or for procedures that don’t have a CPT equivalent.

3. More precise reporting:
   G-codes help Medicare track certain services more accurately, especially for programs like:

   • Quality Payment Program

   • Therapy Cap Reporting

   • Screening and preventive services

4. Functional reporting:
   Some G-codes are used in outpatient therapy to report a patient’s functional status before and after therapy.

Examples:

• G0101 – Cervical or vaginal cancer screening

• G0439 – Annual wellness visit, subsequent

• G0299 – RN services for chronic care

• G8978–G8999 – Functional status codes for physical/occupational therapy

Summary:

G-codes are used to enhance Medicare billing accuracy, fill gaps in CPT coding, and support data tracking and policy enforcement. They are essential for providers billing Medicare for services outside standard CPT coverage.

Read More

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