Opioid Treatment Add-on Code G2078 and G2079 MUE Values

The July 2020 quarterly update for the NCCI added an MUE value of one for OTP HCPCS codes G2067-G2075 and G2078 and G2079.

It was later determined by CMS that the incorrect MUE value was applied to add-on codes G2078 and G2079 and they have updated the MUE value to three for each code. CMS has replaced the MUE file on their Medically Unlikely Edits webpage with the corrected version. This update was made to recognize and allow billing by OTPs that provide up to three weeks of a take-home supply to better assist patients as medically necessary.

NGS updated the editing for G2078 and G2079 on 8/18/2020. Mass adjustments will be performed on associated claims that were processed between 7/1/2020 and 8/18/2020 for dates of service on or after 7/1/2020. No provider action is necessary.

Posted 8/20/2020