G0260 Claims Processing

This article has been published under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

The Systems Department has implemented a correction for Reason Code 5088L, effective for dates of service on or after January 25, 2024:

  • Remove requirement for G0260 to be billed with either imaging codes 77002 OR 77012 to allow payment.
  • The remaining criteria for G0260 to stay the same (Type of Bill 13X and billed with DX listed on the article: M43.28, M46.1, M47.818, or M53.3).
Last Updated Oct 06 , 2026