How To Use HCPCS Code G8450

HCPCS code G8450 describes the use of beta-blocker therapy prescribed for patients with abnormal left ventricular ejection fraction (LVEF). This code is used to indicate that a patient is receiving beta-blocker medication as part of their treatment plan. In this article, we will explore the details of HCPCS code G8450, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G8450?

HCPCS code G8450 is used to identify the prescription of beta-blocker therapy for patients with abnormal LVEF. Beta-blockers are a class of medications that work by blocking the effects of adrenaline on the heart. They are commonly prescribed to treat various heart conditions, including heart failure, high blood pressure, and certain arrhythmias. This code specifically indicates that the patient has an abnormal LVEF, which is a measure of how well the heart is pumping blood.

2. Official Description

The official description of HCPCS code G8450 is “Beta-bloc rx pt w/abn lvef.” This description indicates that the code is used to represent the prescription of beta-blocker therapy for patients with abnormal LVEF.

3. Procedure

1. The provider evaluates the patient’s medical history and performs a physical examination to determine the presence of abnormal LVEF.
2. If the patient is found to have abnormal LVEF, the provider may prescribe beta-blocker therapy as part of the treatment plan.
3. The provider discusses the benefits and potential side effects of beta-blocker therapy with the patient.
4. If the patient agrees to the treatment, the provider writes a prescription for the appropriate beta-blocker medication.
5. The patient fills the prescription at a pharmacy and begins taking the medication as directed by the provider.
6. The provider monitors the patient’s response to the beta-blocker therapy and adjusts the dosage if necessary.

4. When to use HCPCS code G8450

HCPCS code G8450 should be used when a patient with abnormal LVEF is prescribed beta-blocker therapy. It is important to note that this code is specific to the prescription of beta-blockers and should not be used for other medications or treatments.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8450, healthcare providers should ensure that the following documentation is included:

• Medical records indicating the presence of abnormal LVEF
• Prescription for beta-blocker therapy
• Documentation of discussions with the patient regarding the benefits and potential side effects of the medication
• Monitoring records showing the patient’s response to the beta-blocker therapy

Providers should follow the appropriate billing guidelines and submit the necessary documentation to ensure accurate reimbursement for the services rendered.

6. Historical Information and Code Maintenance

HCPCS code G8450 was added to the Healthcare Common Procedure Coding System on January 01, 2008. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code has an effective date of January 01, 2013.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G8450 may vary depending on the specific plan and guidelines. It is important for healthcare providers to verify coverage with the patient’s insurance provider before prescribing beta-blocker therapy. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. The multiple pricing indicator code is 9, which means that the value is not established or the code is not priced separately by Part B.

8. Examples

Here are five examples of when HCPCS code G8450 should be billed:

1. A patient with a history of heart failure and abnormal LVEF is prescribed beta-blocker therapy to improve cardiac function.
2. A patient with high blood pressure and abnormal LVEF is prescribed beta-blocker therapy to lower blood pressure and protect the heart.
3. A patient with a certain arrhythmia and abnormal LVEF is prescribed beta-blocker therapy to regulate heart rhythm and improve cardiac function.
4. A patient who recently had a heart attack and has abnormal LVEF is prescribed beta-blocker therapy to prevent future cardiac events.
5. A patient with a history of coronary artery disease and abnormal LVEF is prescribed beta-blocker therapy to reduce the risk of further complications.