HCPCS code G0455 — Fecal microbiota prep instil.
Status: Active.
Effective Jan 1, 2013.
Source: CMS HCPCS Level II.
G0455
ActiveFecal microbiota prep instil
Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2013
Code type:
alphanumeric
OPPS Status:
T
— Significant procedure — subject to multiple procedure reduction
OPPS APC:
5311
MUE — Medically Unlikely Edits
Maximum units of G0455 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 G0455 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0463 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)