How To Use HCPCS Code G0517

HCPCS code G0517 describes the removal of non-biodegradable drug delivery implants, specifically for subdermal implants. This code is used to identify the service of removing four or more drug implants that are not biodegradable. It is important for medical coders to understand the meaning and usage of this code in order to accurately document and bill for this procedure.

1. What is HCPCS G0517?

HCPCS code G0517 is used to identify the removal of non-biodegradable drug delivery implants, specifically for subdermal implants. This code is applicable when four or more implants are being removed. It is important to note that this code is specifically for non-biodegradable implants, meaning that the implants are not naturally broken down or absorbed by the body over time.

2. Official Description

The official description of HCPCS code G0517 is “Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)”. The short description for this code is “Remove drug implant”. This description accurately reflects the purpose of this code, which is to identify the service of removing non-biodegradable drug delivery implants, specifically for subdermal implants.

3. Procedure

1. The provider begins the procedure by preparing the patient for the removal of the non-biodegradable drug delivery implants.
2. Anesthesia may be administered to ensure the patient’s comfort during the procedure.
3. The provider locates the subdermal implants and carefully removes them from the patient’s body.
4. Once all the implants have been successfully removed, the provider ensures that the area is properly cleaned and dressed.
5. Post-procedure instructions and any necessary follow-up appointments are provided to the patient.

4. When to use HCPCS code G0517

HCPCS code G0517 should be used when a healthcare provider is performing the removal of four or more non-biodegradable drug delivery implants, specifically for subdermal implants. It is important to ensure that the implants being removed are indeed non-biodegradable and that the procedure involves the removal of four or more implants.

5. Billing Guidelines and Documentation Requirements

When billing for the removal of non-biodegradable drug delivery implants using HCPCS code G0517, healthcare providers should ensure that the necessary documentation is in place. This may include medical records indicating the number and type of implants being removed, as well as any relevant pre- and post-procedure documentation. It is important to follow the specific billing guidelines set forth by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0517 was added to the Healthcare Common Procedure Coding System on January 01, 2018. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code remains active and available for use in accurately documenting and billing for the removal of non-biodegradable drug delivery implants.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may provide coverage for the removal of non-biodegradable drug delivery implants using HCPCS code G0517. The pricing indicator code for this code is 13, which indicates that the price is established by carriers. This means that the reimbursement rate for this service may be determined by the individual carrier’s discretion. The multiple pricing indicator code for this code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code G0517 should be billed:

1. A patient has four non-biodegradable drug delivery implants that need to be removed due to the completion of their treatment.
2. A patient has six subdermal implants that are causing discomfort and need to be removed.
3. A patient has five non-biodegradable drug delivery implants that have reached the end of their effectiveness and need to be taken out.
4. A patient has four subdermal implants that have become infected and require removal.
5. A patient has seven non-biodegradable drug delivery implants that need to be removed as part of their treatment plan.