How To Use HCPCS Code G8754

HCPCS code G8754 describes the most recent diastolic blood pressure measurement being less than 90 mmHg. This code is used to indicate a specific threshold for diastolic blood pressure, which is an important indicator of cardiovascular health. In this article, we will explore the details of HCPCS code G8754, 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 G8754?

HCPCS code G8754 is used to identify the most recent diastolic blood pressure measurement being less than 90 mmHg. Diastolic blood pressure represents the pressure in the arteries when the heart is at rest between beats. A diastolic blood pressure measurement below 90 mmHg is considered within the normal range for adults. This code is used to document and track blood pressure readings in medical records and claims.

2. Official Description

The official description of HCPCS code G8754 is “Most recent diastolic blood pressure < 90 mmHg." The short description is "Dias bp less 90." This description accurately reflects the purpose of the code, which is to indicate a diastolic blood pressure measurement below 90 mmHg.

3. Procedure

1. The provider measures the patient’s blood pressure using a sphygmomanometer or an automated blood pressure monitor.
2. The provider records the diastolic blood pressure measurement.
3. If the diastolic blood pressure is less than 90 mmHg, the provider assigns HCPCS code G8754 to indicate this measurement.

4. When to use HCPCS code G8754

HCPCS code G8754 should be used when the most recent diastolic blood pressure measurement is less than 90 mmHg. This code is applicable for patients of all ages and is commonly used in routine blood pressure monitoring during medical visits, screenings, or follow-up appointments. It is important to accurately document the blood pressure measurement to ensure proper coding and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8754, healthcare providers should ensure that the diastolic blood pressure measurement is properly documented in the patient’s medical record. The documentation should include the date of the measurement, the method used to measure blood pressure, and the actual diastolic blood pressure value. This information is crucial for accurate coding and billing.

6. Historical Information and Code Maintenance

HCPCS code G8754 was added to the Healthcare Common Procedure Coding System on January 01, 2012. Since its addition, 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 remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code G8754 is covered by Medicare and other insurance providers. However, it is important to note that the pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established. Providers should review the specific reimbursement policies of Medicare and other insurers to determine the coverage and payment for this code.

8. Examples

Here are five examples of when HCPCS code G8754 should be billed:

1. A patient visits their primary care physician for a routine check-up. The most recent diastolic blood pressure measurement is recorded as 85 mmHg. HCPCS code G8754 should be billed to indicate the diastolic blood pressure measurement below 90 mmHg.
2. A patient with hypertension comes in for a follow-up appointment. The most recent diastolic blood pressure measurement is documented as 88 mmHg. HCPCS code G8754 should be used to indicate the diastolic blood pressure measurement below 90 mmHg.
3. A patient undergoes a pre-operative assessment. The most recent diastolic blood pressure measurement is recorded as 82 mmHg. HCPCS code G8754 should be billed to indicate the diastolic blood pressure measurement below 90 mmHg.
4. A patient participates in a research study monitoring blood pressure. The most recent diastolic blood pressure measurement is documented as 89 mmHg. HCPCS code G8754 should be used to indicate the diastolic blood pressure measurement below 90 mmHg.
5. A patient visits an urgent care clinic for a minor illness. The most recent diastolic blood pressure measurement is recorded as 86 mmHg. HCPCS code G8754 should be billed to indicate the diastolic blood pressure measurement below 90 mmHg.