How To Use HCPCS Code G8739

HCPCS code G8739 describes the left ventricular ejection fraction (LVEF) being equal to or greater than 40%, or documentation indicating normal or mildly depressed left ventricular systolic function. This code is used to identify the level of left ventricular function in patients.

1. What is HCPCS G8739?

HCPCS code G8739 is a specific code used in medical coding to indicate the left ventricular ejection fraction (LVEF) being equal to or greater than 40%, or documentation indicating normal or mildly depressed left ventricular systolic function. It is important for medical coders to accurately assign this code to ensure proper documentation and billing for patients with specific cardiac conditions.

2. Official Description

The official description of HCPCS code G8739 is “Left ventricular ejection fraction (LVEF) >= 40% or documentation as normal or mildly depressed left ventricular systolic function.” This description clearly outlines the criteria for using this code, which is based on the measurement of LVEF or documentation of left ventricular systolic function.

3. Procedure

1. Perform an echocardiogram or other diagnostic test to measure the left ventricular ejection fraction (LVEF).
2. Obtain the LVEF measurement or documentation of normal or mildly depressed left ventricular systolic function.
3. Assign HCPCS code G8739 to indicate the LVEF being equal to or greater than 40% or documentation of normal or mildly depressed left ventricular systolic function.

4. When to use HCPCS code G8739

HCPCS code G8739 should be used when the left ventricular ejection fraction (LVEF) is measured to be equal to or greater than 40%, or when there is documentation indicating normal or mildly depressed left ventricular systolic function. This code is typically used in the context of assessing cardiac function and may be relevant in cases of heart failure, myocardial infarction, or other cardiac conditions.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8739, healthcare providers should ensure that the LVEF measurement or documentation of left ventricular systolic function is clearly documented in the patient’s medical record. This documentation should support the use of this specific code and provide evidence of the patient’s cardiac function. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G8739 was added to the Healthcare Common Procedure Coding System on January 1, 2012. It has a termination date of December 31, 2014. This code is no longer active and should not be used for current billing purposes. It is important for medical coders to stay updated on code changes and ensure the use of current, active codes for accurate billing and reimbursement.

7. Medicare and Insurance Coverage

HCPCS code G8739 may be covered by Medicare and other insurance providers, but coverage may vary depending on the specific policy and medical necessity. It is important for healthcare providers to verify coverage and follow the billing guidelines set forth by Medicare or the respective insurance provider. The pricing indicator code for HCPCS code G8739 is 00, indicating that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating 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 G8739 should be billed:

1. A patient undergoes an echocardiogram, and the LVEF measurement is determined to be 45%. HCPCS code G8739 should be assigned to indicate the LVEF being equal to or greater than 40%.
2. A patient’s medical record includes documentation of normal left ventricular systolic function. HCPCS code G8739 should be assigned to indicate the normal left ventricular systolic function.
3. A patient with a history of heart failure undergoes an echocardiogram, and the LVEF measurement is determined to be 50%. HCPCS code G8739 should be assigned to indicate the LVEF being equal to or greater than 40%.
4. A patient presents with symptoms of chest pain and undergoes an echocardiogram, which shows mildly depressed left ventricular systolic function. HCPCS code G8739 should be assigned to indicate the mildly depressed left ventricular systolic function.
5. A patient with a history of myocardial infarction undergoes an echocardiogram, and the LVEF measurement is determined to be 55%. HCPCS code G8739 should be assigned to indicate the LVEF being equal to or greater than 40%.