HCPCS code G0403 — Ekg for initial prevent exam. Status: Active. Effective Jan 1, 2009. Source: CMS HCPCS Level II.

G0403

Active

Ekg for initial prevent exam

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2009
Code type: alphanumeric
OPPS Status: M — Items / services not billable to the fiscal intermediary or MAC

MUE — Medically Unlikely Edits

Maximum units of G0403 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 G0403 without appropriate documentation.

Column 2 Code Modifier
G0404 Modifier cannot bypass edit
G0405 Modifier cannot bypass edit

Source: CMS National Correct Coding Initiative (NCCI)