How To Use HCPCS Code G8490
HCPCS code G8490 describes the rheumatoid arthritis (RA) measures group. This code is used to report the measures group for patients with rheumatoid arthritis. In this article, we will explore the details of HCPCS code G8490, 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 G8490?
HCPCS code G8490 is used to identify the rheumatoid arthritis (RA) measures group. This code is specifically designed to report the measures group for patients with rheumatoid arthritis. It helps healthcare providers track and measure the quality of care provided to patients with this condition.
2. Official Description
The official description of HCPCS code G8490 is “Ra measures grp.” This short description indicates that this code is used to report the measures group for rheumatoid arthritis.
3. Procedure
- Identify patients with rheumatoid arthritis.
- Collect relevant data and information related to the measures group.
- Report HCPCS code G8490 to indicate the measures group for rheumatoid arthritis.
4. When to use HCPCS code G8490
HCPCS code G8490 should be used when reporting the measures group for patients with rheumatoid arthritis. It is important to ensure that the patient meets the criteria for inclusion in the measures group and that the appropriate data and information are collected to support the use of this code.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code G8490, healthcare providers need to ensure that the necessary documentation is in place to support the use of this code. This may include medical records, test results, and other relevant information that demonstrates the patient’s eligibility for the measures group.
6. Historical Information and Code Maintenance
HCPCS code G8490 was added to the Healthcare Common Procedure Coding System on January 1, 2009. It has a termination date of December 31, 2016. This code is no longer maintained, as indicated by the action code N, which means no maintenance for this code. It is important to use the most up-to-date codes and guidelines when reporting measures groups for rheumatoid arthritis.
7. Medicare and Insurance Coverage
The coverage and pricing of HCPCS code G8490 may vary depending on the specific Medicare or insurance plan. It is important to consult the relevant guidelines and policies to determine if this code is payable and how it is priced by Medicare or other insurers.
8. Examples
Here are five examples of when HCPCS code G8490 should be billed:
- A patient with rheumatoid arthritis undergoes a comprehensive evaluation and management visit, and the measures group data is collected and reported using HCPCS code G8490.
- A rheumatologist provides ongoing care for a patient with rheumatoid arthritis, and the measures group data is documented and reported using HCPCS code G8490.
- A healthcare facility participates in a quality improvement program for rheumatoid arthritis and reports the measures group data using HCPCS code G8490.
- A research study focuses on the effectiveness of different treatment approaches for rheumatoid arthritis, and the measures group data is collected and reported using HCPCS code G8490.
- A healthcare organization implements a care coordination program for patients with rheumatoid arthritis, and the measures group data is documented and reported using HCPCS code G8490.
