In response to the American Academy of Sleep Medicine (AASM) and other organizations, the National Correct Coding Initiative (NCCI), a subsidiary of CMS, is making changes to HCPCS level II codes G0398-G0400, the AASM reports.
The G-Codes, established for type II, III, and IV portable monitoring devices, went into effect on March 13, 2008. After the codes were established, the AASM and other national organizations evaluated and submitted remarks related to Medicare claims. Following the remarks, the NCCI accepted a number of the suggested edits. “The edits pair the G-Codes with those CPT codes describing services that would not be reported separately with the G-Codes when perform[ed] at the same patient encounter,” according to an AASM report. “CMS will also allow the use of modifiers with those edits where at least one organization submitted comment stating that the column two coded procedure could be performed on the same date of service at a separate patient encounter.”
Not all of the AASM’s suggestions will be adopted, however, including the Academy’s recommendation to define a type IV device as a monitor that includes ventilation, respiratory effort, and oxygen saturation.
The edits, which CMS is expected to implement, are available here.