HCPCS code G0238 — Oth resp proc, indiv.
Status: Active.
Effective Oct 1, 2004.
Source: CMS HCPCS Level II.
G0238
ActiveOth resp proc, indiv
Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Oct 1, 2004
Code type:
alphanumeric
OPPS Status:
S
— Significant procedure — not subject to multiple procedure reduction
OPPS APC:
5731
MUE — Medically Unlikely Edits
Maximum units of G0238 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 | 8 |
| Practitioner Services | 8 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits — Reverse Direction
G0238 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0239 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)