HCPCS code G0498 — Chemo extend iv infus w/pump. Status: Active. Effective Jan 1, 2016. Source: CMS HCPCS Level II.

G0498

Active

Chemo extend iv infus w/pump

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2016
Code type: alphanumeric
OPPS Status: S — Significant procedure — not subject to multiple procedure reduction
OPPS APC: 5694

MUE — Medically Unlikely Edits

Maximum units of G0498 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 G0498 without appropriate documentation.

Column 2 Code Modifier
G0463 Modifier may bypass edit
J1644 Modifier may bypass edit

Source: CMS National Correct Coding Initiative (NCCI)

NCCI Edits — Reverse Direction

G0498 cannot be billed together with the following column 1 codes without appropriate documentation.

Column 1 Code Modifier
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

Source: CMS National Correct Coding Initiative (NCCI)