HCPCS code G0516 — Insert drug del implant, >=4.
Status: Active.
Effective Apr 1, 2018.
Source: CMS HCPCS Level II.
G0516
ActiveInsert drug del implant, >=4
Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Apr 1, 2018
Code type:
alphanumeric
OPPS Status:
Q1
— STVX-packaged — paid standalone, packaged when billed with S, T, V, or X
OPPS APC:
5735
MUE — Medically Unlikely Edits
Maximum units of G0516 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 G0516 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| J0670 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)