How To Use HCPCS Code G8600

HCPCS code G8600 describes the initiation of intravenous thrombolytic therapy within 4.5 hours (270 minutes) of the time the patient was last known to be well. This code is used to identify the specific procedure performed by healthcare providers in cases where thrombolytic therapy is administered to dissolve blood clots and restore blood flow in patients who have experienced a stroke.

1. What is HCPCS G8600?

HCPCS code G8600 is used to identify the specific procedure of initiating intravenous thrombolytic therapy within 4.5 hours of the time the patient was last known to be well. This code is specific to cases where thrombolytic therapy is administered to treat stroke patients.

2. Official Description

The official description of HCPCS code G8600 is “Iv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well." The short description for this code is "Tpa initi w/in 4.5 hr."

3. Procedure

1. Perform a thorough assessment of the patient’s medical history, including the time the patient was last known to be well.
2. Confirm the eligibility of the patient for thrombolytic therapy within the 4.5-hour window.
3. Administer intravenous thrombolytic therapy to the patient.
4. Monitor the patient’s vital signs and response to the therapy.
5. Document the procedure and any relevant findings in the patient’s medical record.

4. When to use HCPCS code G8600

HCPCS code G8600 should be used when a healthcare provider initiates intravenous thrombolytic therapy within 4.5 hours of the time the patient was last known to be well. This code is specific to cases where thrombolytic therapy is administered to treat stroke patients who meet the eligibility criteria for the therapy within the specified time frame.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8600, healthcare providers need to document the initiation of intravenous thrombolytic therapy within 4.5 hours of the time the patient was last known to be well. The medical record should include details of the procedure, the patient’s eligibility for the therapy, and any relevant findings or observations. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G8600 was added to the Healthcare Common Procedure Coding System on January 01, 2010. As of January 01, 2023, 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 has been in use for the initiation of intravenous thrombolytic therapy within the specified time frame since its addition to the HCPCS.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G8600 by Medicare and other insurance providers may vary. It is important to check with the specific payer for their coverage policies and guidelines. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, which indicates that the code is not applicable for separate pricing by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G8600 should be billed:

1. A patient arrives at the emergency department within 4.5 hours of the time they were last known to be well and meets the eligibility criteria for intravenous thrombolytic therapy. The healthcare provider initiates the therapy, and HCPCS code G8600 is billed.
2. A stroke patient is transferred from another facility to a hospital within 4.5 hours of the time they were last known to be well. The receiving healthcare provider initiates intravenous thrombolytic therapy, and HCPCS code G8600 is billed.
3. A patient experiences a stroke and is brought to the hospital by emergency medical services within 4.5 hours of the time they were last known to be well. The healthcare provider initiates intravenous thrombolytic therapy, and HCPCS code G8600 is billed.
4. A stroke patient presents to a primary care physician’s office within 4.5 hours of the time they were last known to be well. The physician determines the patient’s eligibility for intravenous thrombolytic therapy and initiates the therapy. HCPCS code G8600 is billed.
5. A patient is admitted to the hospital with stroke symptoms within 4.5 hours of the time they were last known to be well. The healthcare provider initiates intravenous thrombolytic therapy, and HCPCS code G8600 is billed.