HCPCS code G0423 — Intens cardiac rehab no exer.
Status: Active.
Effective Jan 1, 2010.
Source: CMS HCPCS Level II.
G0423
ActiveIntens cardiac rehab no exer
Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2010
Code type:
alphanumeric
OPPS Status:
S
— Significant procedure — not subject to multiple procedure reduction
OPPS APC:
5771
MUE — Medically Unlikely Edits
Maximum units of G0423 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 | 6 |
| Practitioner Services | 6 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with G0423 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0471 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
NCCI Edits — Reverse Direction
G0423 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0422 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)