Update to facility editing: HCPCS code G0463

We are enhancing our outpatient facility editing to help align with correct coding guidelines for usage of HCPCS code G0463.

 

The code description for G0463 is “hospital outpatient clinic visit for assessment and management of a patient”. Based on this code description, HCPCS code G0463, should only be billed with revenue codes which support the billing of clinic visits/assessment and management services. When G0463 is billed with an inappropriate revenue code, it will be denied.

 

For assistance with coding guidelines, the National Uniform Billing Committee (NUBC) is a valuable resource.

 

MULTI-BCBS-COMM-002028-22-CPN1882