G0248
ActiveDemonstrate use home inr mon
Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
MUE — Medically Unlikely Edits
Maximum units of G0248 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
G0248 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0337 | Modifier cannot bypass edit |
| G0398 | Modifier cannot bypass edit |
| G0399 | Modifier cannot bypass edit |
| G0400 | Modifier cannot bypass edit |
| G0463 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)