HCPCS code G0428 — Collagen meniscus implant. Status: Active. Effective May 25, 2010. Source: CMS HCPCS Level II.

G0428

Active

Collagen meniscus implant

Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: May 25, 2010
Code type: alphanumeric
OPPS Status: E1 — Items / services not paid by Medicare

MUE — Medically Unlikely Edits

Maximum units of G0428 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 0
Practitioner Services 0

Source: CMS Medicare NCCI Medically Unlikely Edits

NCCI Edits

The following codes cannot be billed together with G0428 without appropriate documentation.

Column 2 Code Modifier
G0471 Modifier may bypass edit

Source: CMS National Correct Coding Initiative (NCCI)