HCPCS code G0276 — Pild/placebo control clin tr. Status: Active. Effective Jan 1, 2015. Source: CMS HCPCS Level II.

G0276

Active

Pild/placebo control clin tr

Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2015
Code type: alphanumeric
OPPS Status: J1 — Hospital Part B services paid through a comprehensive APC (C-APC)
OPPS APC: 5114

MUE — Medically Unlikely Edits

Maximum units of G0276 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

The following codes cannot be billed together with G0276 without appropriate documentation.

Column 2 Code Modifier
G0453 Modifier cannot bypass edit

Source: CMS National Correct Coding Initiative (NCCI)