HCPCS code G2013 — Post-d/c h vst ext pt 75 m.
Status: Active.
Effective Jan 1, 2019.
Source: CMS HCPCS Level II.
G2013
ActivePost-d/c h vst ext pt 75 m
Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2019
Code type:
alphanumeric
OPPS Status:
B
— Code not recognized by OPPS — billed via another route
MUE — Medically Unlikely Edits
Maximum units of G2013 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 G2013 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0076 | Modifier cannot bypass edit |
| G0077 | Modifier cannot bypass edit |
| G0078 | Modifier cannot bypass edit |
| G0079 | Modifier cannot bypass edit |
| G0080 | Modifier cannot bypass edit |
| G0081 | Modifier cannot bypass edit |
| G0082 | Modifier cannot bypass edit |
| G0083 | Modifier cannot bypass edit |
| G0084 | Modifier cannot bypass edit |
| G0085 | Modifier cannot bypass edit |
| G0086 | Modifier cannot bypass edit |
| G0087 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)