2013 fee schedule: Get ready to comply with new G-code billing rules

Why This Topic Matters

These updates affect how certain services are reported and paid under Medicare and may also influence how some non-Medicare payers handle the same services. The article helps readers track new G-code requirements, associated CPT references, and the broader coverage context for affected specialties and workflows.

Article Sections

1. G0454 for DME face-to-face visits

   Covers Medicare reporting changes related to documentation for durable medical equipment orders and the associated supplier documentation workflow. The section also discusses who may perform the visit and the general compliance context.

2. G0456, G0457 for negative pressure wound therapy (when it includes supplies)

   Summarizes new Medicare payment codes for negative pressure wound therapy services when supplies are included. The section notes the relationship to existing CPT wound vac codes and the interim pricing status.

3. G0452 for molecular pathology interpretation

   Explains Medicare coverage and payment context for physician interpretation of molecular pathology testing. The section focuses on the role of the new HCPCS code and the related laboratory fee schedule setting.

4. G0453 for remote intraoperative monitoring

   Discusses changes to intraoperative neurophysiological monitoring coding and Medicare’s separate treatment of remote monitoring. The section addresses the new HCPCS code in the broader monitoring context.

5. G0455 for fecal bacteriotherapy

   Covers the Medicare HCPCS code created for fecal microbiota preparation and instillation in a bacteriotherapy setting. The section places the code in the context of related CPT references and coverage concerns.