How To Use HCPCS Code G8859

HCPCS code G8859 describes the use of corticosteroids in patients who receive a dosage of 10mg or greater per day for a consecutive period of 60 days or more. This code is used to identify and bill for the administration of corticosteroids in these specific circumstances.

1. What is HCPCS G8859?

HCPCS code G8859 is a specific code used in medical coding to identify and bill for the administration of corticosteroids in patients who receive a dosage of 10mg or greater per day for a consecutive period of 60 days or more. This code is used to accurately document and track the use of corticosteroids in these specific circumstances.

2. Official Description

The official description of HCPCS code G8859 is “Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days.” This description clearly outlines the specific criteria that must be met in order to use this code for billing purposes. The short description of this code is “Corticosteroids 10mg 60 days,” which provides a concise summary of the code’s purpose.

3. Procedure

1. The healthcare provider must first determine if the patient meets the criteria for receiving corticosteroids at a dosage of 10mg or greater per day.
2. If the patient meets the criteria, the provider will administer the corticosteroids to the patient on a daily basis for a consecutive period of 60 days or more.
3. The provider must accurately document the dosage and duration of corticosteroid administration for each patient.
4. At the end of the 60-day period, the provider can use HCPCS code G8859 to bill for the administration of corticosteroids.

4. When to use HCPCS code G8859

HCPCS code G8859 should be used when a patient meets the specific criteria of receiving corticosteroids at a dosage of 10mg or greater per day for a consecutive period of 60 days or more. It is important to accurately document and track the use of corticosteroids in order to ensure proper billing and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of corticosteroids using HCPCS code G8859, healthcare providers must ensure that the following documentation requirements are met:

• Documentation of the patient’s medical condition necessitating the use of corticosteroids
• Documentation of the dosage and duration of corticosteroid administration
• Documentation of the patient’s response to the corticosteroid treatment
• Documentation of any adverse reactions or side effects experienced by the patient

These documentation requirements are essential for accurate billing and reimbursement for the administration of corticosteroids.

6. Historical Information and Code Maintenance

HCPCS code G8859 was added to the Healthcare Common Procedure Coding System on January 1, 2012. It has an effective date of January 1, 2015. This code was terminated on December 31, 2014, indicating that it is no longer in use for billing purposes. 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 have specific coverage policies and guidelines for the use of HCPCS code G8859. It is important to consult with the individual payer to determine if this code is payable and to understand any specific requirements for reimbursement. The pricing indicator code for HCPCS code G8859 is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G8859 should be billed:

1. A patient with a chronic inflammatory condition receives a daily dosage of 15mg of corticosteroids for 90 consecutive days.
2. A patient with severe asthma requires a daily dosage of 20mg of corticosteroids for 75 consecutive days.
3. A patient with rheumatoid arthritis receives a daily dosage of 12mg of corticosteroids for 120 consecutive days.
4. A patient with a severe skin condition requires a daily dosage of 10mg of corticosteroids for 60 consecutive days.
5. A patient with a chronic lung disease receives a daily dosage of 18mg of corticosteroids for 180 consecutive days.