G0042 : HCPCS Code (FY2024)
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G0042 HCPCS Code Description |
| HCPCS Code | G0042 |
| The Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into two levels, or groups, as described Below: Level I Codes and descriptors copyrighted by the American Medical Association's current procedural terminology, fourth edition (CPT-4). These are 5 position numeric codes representing physician and nonphysician services. **** NOTE: **** CPT-4 codes including both long and short descriptions shall be used in accordance with the CMS/AMA agreement. Any other use violates the AMA copyright. Level II Includes codes and descriptors copyrighted by the American Dental Association's current dental terminology, (CDT-2018). These are 5 position alpha-numeric codes comprising the d series. All level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 5 position alpha- numeric codes representing primarily items and nonphysician services that are not represented in the level I codes. |
| Short Description | REF TO THERAPY |
| Short descriptive text of procedure or modifier code (28 characters or less). The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law. |
| Code Description | REFERRAL TO PHYSICAL, OCCUPATIONAL, SPEECH, OR RECREATIONAL THERAPY |
| Contains all text of procedure or modifier long descriptions. As of 2013, this field contains the consumer friendly descriptions for the AMA CPT codes. The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law. |
G0042 HCPCS Code Pricing Indicators |
| Multiple Pricing Indicator Code | 9 |
| Code used to identify instances where a procedure could be priced under multiple methodologies. |
| Multiple Pricing Indicator Code Description | NOT APPLICABLE AS HCPCS NOT PRICED SEPARATELY BY PART B (PRICING INDICATOR IS 00) OR VALUE IS NOT ESTABLISHED (PRICING INDICATOR IS '99') |
| Multiple Pricing Indicator Code Description |
| Pricing Indicator Code #1 | 00 |
| Code used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes. |
| Pricing Indicator Code #1 Description | SERVICE NOT SEPARATELY PRICED BY PART B (E.G., SERVICES NOT COVERED, BUNDLED, USED BY PART A ONLY, ETC.) |
| Description of Pricing Indicator Code #1 |
PLACE YOUR
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G0042 HCPCS Code Dates, Status, Action |
| Status | ACTUAL |
Possible status values: - Actual Actual HCPCS Code
- Discontinued Discontinued HCPCS Code
|
| Code Added Date | 20220101 |
| The year the HCPCS code was added to the Healthcare common procedure coding system. |
| Last Update Date | 2024 |
| The date that a record was last updated or changed. |
| Action Effective Date | 20220101 |
| Effective date of action to a procedure or modifier code |
| Termination Date | N/S (NOT SPECIFIED) |
| Last date for which a procedure or modifier code may be used by Medicare providers. |
| Action Code | N |
| A code denoting the change made to a procedure or modifier code within the HCPCS system. |
| Action Code Description | NO MAINTENANCE FOR THIS CODE |
| Action Code Description |
| Anesthesia Base Unit Quantity | 0 |
| The base unit represents the level of intensity for anesthesia procedure services that reflects all activities except time. These activities include usual preoperative and post-operative visits, the administration of fluids and/or blood incident to anesthesia care, and monitering procedures. (Note: the payment amount for anesthesia services is based on a calculation using base unit, time units, and the conversion factor.) |
| Processing Note Number | N/S (NOT SPECIFIED) |
| Number identifying the processing note contained in Appendix A of the HCPCS manual. |
| Berenson-Eggers Type Of Service Code | Z2 |
| This field is valid beginning with 2003 data. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services. |
| Berenson-Eggers Type Of Service Code Description | UNDEFINED CODES |
| Berenson-Eggers Type Of Service Code Description |
G0042 HCPCS Code Manual Reference Section Numbers |
| Coverage Issues Manual Reference Section Number #1 | N/S (NOT SPECIFIED) |
| Number identifying the reference section of the coverage issues manual. |
| Coverage Issues Manual Reference Section Number #2 | N/S (NOT SPECIFIED) |
| Number identifying the reference section of the coverage issues manual. |
| Coverage Issues Manual Reference Section Number #3 | N/S (NOT SPECIFIED) |
| Number identifying the reference section of the coverage issues manual. |
| Medicare Carriers Manual Reference Section Number #1 | N/S (NOT SPECIFIED) |
| Number identifying a section of the Medicare carriers manual. |
| Medicare Carriers Manual Reference Section Number #2 | N/S (NOT SPECIFIED) |
| Number identifying a section of the Medicare carriers manual. |
| Medicare Carriers Manual Reference Section Number #3 | N/S (NOT SPECIFIED) |
| Number identifying a section of the Medicare carriers manual. |
| Statute Number | N/S (NOT SPECIFIED) |
| Number identifying statute reference for coverage or noncoverage of procedure or service. |
G0042 HCPCS Code Lab Certifications |
| Lab Certification Code #1 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #1 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #1 |
| Lab Certification Code #2 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #2 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #2 |
| Lab Certification Code #3 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #3 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #3 |
| Lab Certification Code #4 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #4 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #4 |
| Lab Certification Code #5 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #5 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #5 |
| Lab Certification Code #6 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #6 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #6 |
| Lab Certification Code #7 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #7 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #7 |
| Lab Certification Code #8 | N/S (NOT SPECIFIED) |
| Code used to classify laboratory procedures according to the specialty certification categories listed by CMS. Any generally certified laboratory (e.g., 100) may perform any of the tests in its subgroups (e.g., 110, 120, etc.). |
| Lab Certification Code #8 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Lab Certification Code #8 |
G0042 HCPCS Code Cross Reference Codes |
| Cross Reference Code #1 | N/S (NOT SPECIFIED) |
| An explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). |
| Cross Reference Code #1 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Cross Reference Code #1 |
| Cross Reference Code #2 | N/S (NOT SPECIFIED) |
| An explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). |
| Cross Reference Code #2 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Cross Reference Code #2 |
| Cross Reference Code #3 | N/S (NOT SPECIFIED) |
| An explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). |
| Cross Reference Code #3 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Cross Reference Code #3 |
| Cross Reference Code #4 | N/S (NOT SPECIFIED) |
| An explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). |
| Cross Reference Code #4 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Cross Reference Code #4 |
| Cross Reference Code #5 | N/S (NOT SPECIFIED) |
| An explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). |
| Cross Reference Code #5 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Cross Reference Code #5 |
G0042 HCPCS Code Coverage, Payment Groups, Payment Policy Indicators |
| Coverage Code | C |
| A code denoting Medicare coverage status. |
| Coverage Code Description | CARRIER JUDGMENT |
| Coverage Code Description |
| ASC Payment Group Code | N/S (NOT SPECIFIED) |
| The 'YY' indicator represents that this procedure is approved to be performed in an ambulatory surgical center. You must access the ASC tables on the mainframe or CMS website to get the dollar amounts. |
| ASC Payment Group Effective Date | N/S (NOT SPECIFIED) |
| The date the procedure is assigned to the ASC payment group. |
| MOG Payment Group Code | N/S (NOT SPECIFIED) |
| Medicare outpatient groups (MOG) payment group code |
| MOG Payment Group Code Description | N/S (NOT SPECIFIED) |
| HCPCS MOG payment group code. 1St digit indicates the body system 2nd digit is sequential numbering within the body system 3rd digit is the level of intensity where: '1', '2', '3' or '4' represents levels for a given group type '0' and '9' represent single level for a given group type |
| MOG Payment Policy Indicator | N/S (NOT SPECIFIED) |
| Indicator identifying whether a HCPCS code is subject to payment of an ASC facility fee, to a separate fee under another provision of Medicare, or to no fee at all. |
| MOG Payment Policy Indicator Description | N/S (NOT SPECIFIED) |
| Description of HCPCS MOG Payment Policy Indicator |
| MOG Effective Date | N/S (NOT SPECIFIED) |
| The date the procedure is assigned to the Medicare outpatient group (MOG) payment group. |
G0042 HCPCS Code Type Of Service Codes |
| Type Of Service Code #1 | 1 |
| The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. |
| Type Of Service Code #1 Description | MEDICAL CARE |
| Description of HCPCS Type Of Service Code #1 |
| Type Of Service Code #2 | N/S (NOT SPECIFIED) |
| The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. |
| Type Of Service Code #2 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Type Of Service Code #2 |
| Type Of Service Code #3 | N/S (NOT SPECIFIED) |
| The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. |
| Type Of Service Code #3 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Type Of Service Code #3 |
| Type Of Service Code #4 | N/S (NOT SPECIFIED) |
| The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. |
| Type Of Service Code #4 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Type Of Service Code #4 |
| Type Of Service Code #5 | N/S (NOT SPECIFIED) |
| The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. |
| Type Of Service Code #5 Description | N/S (NOT SPECIFIED) |
| Description of HCPCS Type Of Service Code #5 |
G0042 : HCPCS Code (FY2024) 
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JSON formats. Similar HCPCS codes may be found here : SIMILAR HCPCS CODES . Find HCPCS G0042 code data using HIPAASpace API : API