How To Use HCPCS Code G8860

HCPCS code G8860 describes patients who have received a dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days. This code is used to identify and bill for the specific treatment provided to these patients. In this article, we will explore the details of HCPCS code G8860, 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 G8860?

HCPCS code G8860 is a specific code used in medical coding to identify patients who have received a dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days. It is important to accurately assign this code to ensure proper documentation and billing for the treatment provided to these patients.

2. Official Description

The official description of HCPCS code G8860 is “Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days.” The short description of this code is “Corticosteroid 10 mg 60 days.”

3. Procedure

1. The provider assesses the patient’s medical history and determines the need for corticosteroid treatment.
2. The provider prescribes a dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days.
3. The patient follows the prescribed treatment plan, taking the corticosteroids as directed by the provider.
4. The provider monitors the patient’s response to the treatment and adjusts the dosage if necessary.
5. The provider documents the details of the treatment, including the dosage, duration, and any observed side effects or complications.

4. When to use HCPCS code G8860

HCPCS code G8860 should be used when documenting and billing for patients who have received a dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days. It is important to ensure that the patient meets the specific criteria outlined in the code description before assigning this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8860, healthcare providers need to document the following information:

• Date of initiation of corticosteroid treatment
• Dosage of corticosteroids prescribed
• Duration of treatment (60 or greater consecutive days)
• Any observed side effects or complications

Providers should also ensure that the medical record supports the medical necessity of the treatment and includes any relevant clinical documentation.

6. Historical Information and Code Maintenance

HCPCS code G8860 was added to the Healthcare Common Procedure Coding System on January 01, 2012. It has an effective date of January 01, 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 insurance coverage for HCPCS code G8860 may vary. It is important to check with the specific payer for their coverage policies and guidelines. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are some examples of when HCPCS code G8860 should be billed:

1. Example 1: A patient with a chronic inflammatory condition has been prescribed a daily dose of 15mg of corticosteroids for the past 70 consecutive days.
2. Example 2: A patient with severe asthma has been receiving a daily dose of 20mg of corticosteroids for the past 80 consecutive days.
3. Example 3: A patient with rheumatoid arthritis has been on a daily dose of 10mg of corticosteroids for the past 90 consecutive days.
4. Example 4: A patient with a severe skin condition has been prescribed a daily dose of 12mg of corticosteroids for the past 65 consecutive days.
5. Example 5: A patient with a chronic lung disease has been receiving a daily dose of 18mg of corticosteroids for the past 75 consecutive days.