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G0453 and 95813 Bundled

Eleen Posted Fri 17th of February, 2017 09:45:07 AM
Getting the following edit: Per Medicaid National Correct Coding Initiative edits, Procedure Code G0453 [CONT IO NEUROPHYSIOL MON OUTSD OR-PT EA 15 MIN] has an unbundle relationship with Procedure Code 95813 [ELECTROENCEPHALOGRAM EXTND MNTR >1 HR] on Claim 522741950, Ext/Int Line ID [2/2]. Review documentation to determine if a modifier is appropriate. Is there anymore information on the bundling of these two codes? I am unable to find much. Thank you
SuperCoder Answered Mon 20th of February, 2017 07:09:02 AM


Our team is working on it and will get back soon.

SuperCoder Answered Wed 22nd of February, 2017 04:08:41 AM


For reimbursement of CPT code 95813 {Electroencephalogram (EEG) extended monitoring; greater than 1 hour} and G0453 {Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)} there should be a separate report for each test and append XU modifier with G0453 otherwise it will not be paid.

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