HCPCS code G0492 — Md/oth eval acut kid no esrd.
Status: Active.
Effective Jan 1, 2017.
Source: CMS HCPCS Level II.
G0492
ActiveMd/oth eval acut kid no esrd
Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2017
Code type:
alphanumeric
OPPS Status:
B
— Code not recognized by OPPS — billed via another route
MUE — Medically Unlikely Edits
Maximum units of G0492 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 G0492 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0271 | Modifier cannot bypass edit |
| G0380 | Modifier may bypass edit |
| G0381 | Modifier may bypass edit |
| G0382 | Modifier may bypass edit |
| G0383 | Modifier may bypass edit |
| G0384 | Modifier may bypass edit |
| G0463 | Modifier may bypass edit |
| G0471 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
NCCI Edits — Reverse Direction
G0492 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0257 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)