💡 CPT Code G0463 is used for hospital outpatient clinic visits for the assessment and management of a patient. This code can be billed alone or alongside a procedure—if the visit is separate and distinct from the procedure.
đź“Ť Where it applies:
-On-campus or off-campus hospital outpatient departments.
-Use Modifier PN for services at non-excepted off-campus provider-based departments (PBDs).
đź“ť Documentation Tips:
-Clearly record the patient’s condition, symptoms, and any tests/procedures done.
-Ensure the encounter is identifiable as separate from any procedure.
⚠️ Revenue Code Reminder:
-Revenue code 0761 is for treatment room procedures—not for E/M services like G0463 or 99202–99215.
Stephanie Allard Consulting, LLC
💡 CPT Code G0463 is used for hospital outpatient clinic visits for the assessment and management of a patient. This code can be billed alone or alongside a procedure—if the visit is separate and distinct from the procedure.
đź“Ť Where it applies:
-On-campus or off-campus hospital outpatient departments.
-Use Modifier PN for services at non-excepted off-campus provider-based departments (PBDs).
đź“ť Documentation Tips:
-Clearly record the patient’s condition, symptoms, and any tests/procedures done.
-Ensure the encounter is identifiable as separate from any procedure.
⚠️ Revenue Code Reminder:
-Revenue code 0761 is for treatment room procedures—not for E/M services like G0463 or 99202–99215.
âś… Accurate coding + clear documentation = proper reimbursement & compliance.
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