HCPCS code G0458 — Ldr prostate brachy comp rat. Status: Active. Effective Jan 1, 2018. Source: CMS HCPCS Level II.

G0458

Active

Ldr prostate brachy comp rat

Low dose rate (ldr) prostate brachytherapy services, composite rate

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2018
Code type: alphanumeric
OPPS Status: B — Code not recognized by OPPS — billed via another route

MUE — Medically Unlikely Edits

Maximum units of G0458 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 G0458 without appropriate documentation.

Column 2 Code Modifier
G0471 Modifier cannot bypass edit
G0500 Modifier cannot bypass edit
P9612 Modifier cannot bypass edit

Source: CMS National Correct Coding Initiative (NCCI)