Does G0453 require prior authorization?

No, G0453 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for G0453?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.60.

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`G0453`, Continuous intraoperative neurophysiology monitoring, from outside the

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.60

Facility

N/A

Non-Facility

N/A

Documentation Required

All documentation must be maintained in the patient's medical record and made available to the contractor upon request; every page must be legible and include patient identification and dates of service.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing care to the patient.

Key Coverage Criteria

Continuous intraoperative neurophysiologic monitoring provided one-on-one in the operating room (CPT 95940) is covered when it supports the covered indications in LCD L35003.
Report continuous intraoperative neurophysiologic monitoring in the operating room (95940) in addition to monitoring services provided from outside the operating room (G0453); coverage includes interpretation of baseline studies and removal of electrodes at the end of the procedure when supporting the LCD indications.
Reimbursement may be made for covered intraoperative monitoring when performed at POS 19, POS 21, POS 22, or POS 24.
Intraoperative neurophysiological testing is billable only when coverage criteria and medical necessity in related LCD L34623 are met.
G03.9 Meningitis, unspecified [lumbar arachnoiditis]
G54.6 - G54.7 Phantom limb syndrome

14 Active Policies

A57604, Billing and Coding: Intraoperative Neurophysiological Testing

WPS-J5-L34623, Intraoperative Neurophysiological Testing

WPS-J8-L34623, Intraoperative Neurophysiological Testing

NOVITAS-JH-L35003, Intraoperative Neurophysiological Testing

NOVITAS-JL-L35003, Intraoperative Neurophysiological Testing

A56722, Billing and Coding: Intraoperative Neurophysiological Testing

BCBSNM-MED205.011, Intraoperative Neurophysiologic Monitoring (IONM)

BCBSOK-MED205.011, Intraoperative Neurophysiologic Monitoring (IONM)

AMBETTER-CP.MP.134, Evoked Potential Testing

AETNA-CPB-0194, Spinal Cord Stimulation

AETNA-CPB-0502, Electrodiagnostic Testing

ANTHEM-CG-SURG-104, Intraoperative Neurophysiological Monitoring

BCBSIL-MED205.011, Intraoperative Neurophysiologic Monitoring (IONM)

BCBSMT-MED205.011, Intraoperative Neurophysiologic Monitoring (IONM)

`G0453`, Continuous intraoperative neurophysiology monitoring, from outside the

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

14 Active Policies

Related Codes

Have a follow-up question?

G0453, Continuous intraoperative neurophysiology monitoring, from outside the

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

14 Active Policies

Related Codes

Have a follow-up question?

`G0453`, Continuous intraoperative neurophysiology monitoring, from outside the