HCPCS code G0081 — Care man h v ext pt 20 mi.
Status: Active.
Effective Jan 1, 2019.
Source: CMS HCPCS Level II.
G0081
ActiveCare man h v ext pt 20 mi
Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2019
Code type:
alphanumeric
OPPS Status:
B
— Code not recognized by OPPS — billed via another route
MUE — Medically Unlikely Edits
Maximum units of G0081 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits — Reverse Direction
G0081 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G2001 | Modifier cannot bypass edit |
| G2002 | Modifier cannot bypass edit |
| G2003 | Modifier cannot bypass edit |
| G2004 | Modifier cannot bypass edit |
| G2005 | Modifier cannot bypass edit |
| G2006 | Modifier cannot bypass edit |
| G2007 | Modifier cannot bypass edit |
| G2008 | Modifier cannot bypass edit |
| G2009 | Modifier cannot bypass edit |
| G2013 | Modifier cannot bypass edit |
| G2014 | Modifier cannot bypass edit |
| G2015 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)