How To Use HCPCS Code G8718

HCPCS code G8718 describes the total kt/v greater than or equal to 1.7 per week, which refers to the total clearance of urea (kt) divided by the volume (v) in hemodialysis patients. This code is used to indicate the adequacy of dialysis treatment and is an important measure in assessing the effectiveness of the dialysis process.

1. What is HCPCS G8718?

HCPCS code G8718 is a specific code used in medical coding to identify the total kt/v value in hemodialysis patients. It represents the ratio of the total clearance of urea (kt) to the volume (v) in a week. This code is essential in evaluating the adequacy of dialysis treatment and ensuring that patients receive the appropriate level of care.

2. Official Description

The official description of HCPCS code G8718 is “Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v]).” The short description for this code is “Great 1.7 kt/v per week.”

3. Procedure

1. The provider calculates the total clearance of urea (kt) for a hemodialysis patient.
2. The provider determines the volume (v) of dialysis treatment received by the patient in a week.
3. The provider divides the total clearance of urea (kt) by the volume (v) to obtain the kt/v ratio.
4. If the kt/v ratio is greater than or equal to 1.7, the provider assigns HCPCS code G8718 to indicate the adequacy of dialysis treatment.

4. When to use HCPCS code G8718

HCPCS code G8718 should be used when the total kt/v ratio in a hemodialysis patient is greater than or equal to 1.7 per week. This code is used to indicate that the dialysis treatment is providing sufficient clearance of urea and maintaining the appropriate volume for the patient’s needs.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8718, healthcare providers need to document the calculation of the total clearance of urea (kt) and the volume (v) of dialysis treatment received by the patient. This documentation should support the assignment of the code and demonstrate the adequacy of the dialysis treatment provided.

6. Historical Information and Code Maintenance

HCPCS code G8718 was added to the Healthcare Common Procedure Coding System on January 1, 2012. It has a termination date of December 31, 2015. No maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the services associated with HCPCS code G8718. 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, indicating that the value for pricing is not established. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of when HCPCS code G8718 should be billed:

1. A hemodialysis patient receives three sessions of dialysis per week, with a total clearance of urea of 60 mL/min and a volume of dialysis treatment of 35 liters. The kt/v ratio is calculated as 60/35 = 1.71, which is greater than 1.7. HCPCS code G8718 should be billed to indicate the adequacy of dialysis treatment.
2. Another hemodialysis patient receives four sessions of dialysis per week, with a total clearance of urea of 70 mL/min and a volume of dialysis treatment of 40 liters. The kt/v ratio is calculated as 70/40 = 1.75, which is greater than 1.7. HCPCS code G8718 should be billed to indicate the adequacy of dialysis treatment.
3. A third hemodialysis patient receives two sessions of dialysis per week, with a total clearance of urea of 50 mL/min and a volume of dialysis treatment of 30 liters. The kt/v ratio is calculated as 50/30 = 1.67, which is less than 1.7. HCPCS code G8718 should not be billed as the adequacy of dialysis treatment does not meet the threshold.
4. In a different case, a hemodialysis patient receives five sessions of dialysis per week, with a total clearance of urea of 80 mL/min and a volume of dialysis treatment of 45 liters. The kt/v ratio is calculated as 80/45 = 1.78, which is greater than 1.7. HCPCS code G8718 should be billed to indicate the adequacy of dialysis treatment.
5. Lastly, a hemodialysis patient receives three sessions of dialysis per week, with a total clearance of urea of 55 mL/min and a volume of dialysis treatment of 32 liters. The kt/v ratio is calculated as 55/32 = 1.72, which is greater than 1.7. HCPCS code G8718 should be billed to indicate the adequacy of dialysis treatment.