How To Use HCPCS Code G8749
HCPCS code G8749 describes the absence of signs or symptoms of melanoma that would suggest systemic spread. This code is used to indicate that there are no physical signs such as tenderness, jaundice, or localized neurologic signs, and no symptoms such as cough, dyspnea, pain, or paresthesia that would indicate the possibility of melanoma spreading throughout the body.
1. What is HCPCS G8749?
HCPCS code G8749 is a specific code used in medical coding to identify the absence of signs or symptoms of melanoma that would suggest systemic spread. It is important to note that this code does not indicate the presence of melanoma, but rather the absence of signs or symptoms that would indicate its spread.
2. Official Description
The official description of HCPCS code G8749 is “Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma).” The short description for this code is “No signs melanoma.”
3. Procedure
- The healthcare provider should thoroughly examine the patient for any signs or symptoms of melanoma.
- If there are no signs of melanoma such as tenderness, jaundice, or localized neurologic signs, the provider should document this information.
- If there are no symptoms of melanoma such as cough, dyspnea, pain, or paresthesia, the provider should also document this information.
- The absence of signs and symptoms should be clearly indicated in the patient’s medical record.
4. When to use HCPCS code G8749
HCPCS code G8749 should be used when there are no signs or symptoms of melanoma that would suggest systemic spread. This code is applicable when the patient does not exhibit any physical signs such as tenderness, jaundice, or localized neurologic signs, and does not experience any symptoms such as cough, dyspnea, pain, or paresthesia that would indicate the possibility of melanoma spreading throughout the body.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code G8749, healthcare providers should ensure that the absence of signs and symptoms of melanoma is clearly documented in the patient’s medical record. This documentation should include a thorough examination of the patient and a detailed description of the absence of any signs or symptoms that would suggest systemic spread of melanoma.
6. Historical Information and Code Maintenance
HCPCS code G8749 was added to the Healthcare Common Procedure Coding System on January 01, 2012. As of the effective date of January 01, 2019, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.
7. Medicare and Insurance Coverage
HCPCS code G8749 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service is either not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which means that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.
8. Examples
Here are five examples of when HCPCS code G8749 should be billed:
- A patient undergoes a thorough examination for signs and symptoms of melanoma, and no indications of systemic spread are found.
- A patient with a history of melanoma presents for a follow-up visit, and there are no signs or symptoms of systemic spread.
- A patient reports a skin lesion that is suspected to be melanoma, but upon examination, no signs or symptoms of systemic spread are present.
- A patient with a family history of melanoma undergoes a screening, and no signs or symptoms of systemic spread are detected.
- A patient with a previous diagnosis of melanoma undergoes regular check-ups, and there are no signs or symptoms of systemic spread during the latest visit.
