How To Use HCPCS Code G8863

HCPCS code G8863 describes a situation where patients have not been assessed for the risk of bone loss, and the reason for not conducting the assessment is not provided. This code falls under the category of “No assess bone loss” and is classified under the HCPCS Coverage Code C, which indicates that the carrier has the discretion to determine coverage for this code. The HCPCS Action Code N signifies that there is no maintenance for this code, and it became effective on January 01, 2013. The code was added to the HCPCS on January 01, 2012.

1. What is HCPCS G8863?

HCPCS code G8863 is used to identify cases where patients have not undergone an assessment for the risk of bone loss, and the reason for not conducting the assessment is not specified. This code is specific to situations where bone loss assessment has not taken place, and it does not provide any further details regarding the patient’s condition or the healthcare provider’s actions.

2. Official Description

The official description of HCPCS code G8863 is “Patients not assessed for risk of bone loss, reason not given.” The short description for this code is “No assess bone loss.”

3. Procedure

1. As HCPCS code G8863 does not involve a specific procedure, there are no step-by-step instructions for healthcare providers to follow.

4. When to use HCPCS code G8863

HCPCS code G8863 should be used when documenting cases where patients have not been assessed for the risk of bone loss, and the reason for not conducting the assessment is not provided. It is important to accurately report this code when it applies to ensure proper documentation and billing.

5. Billing Guidelines and Documentation Requirements

When using HCPCS code G8863, healthcare providers should ensure that the medical records clearly indicate that the patient has not undergone an assessment for the risk of bone loss, and the reason for not conducting the assessment is not specified. It is essential to provide accurate and detailed documentation to support the use of this code during the billing process.

6. Historical Information and Code Maintenance

HCPCS code G8863 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. The code became effective on January 01, 2013, and there have been no significant changes or revisions to it since then.

7. Medicare and Insurance Coverage

Medicare and other insurance coverage for HCPCS code G8863 may vary. It is important to consult the specific guidelines and policies of the respective payers to determine if this code is payable. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the service may not be covered, bundled, or used solely by Part A. The multiple pricing indicator code is 9, which signifies that the value for this code is not established or applicable as HCPCS G8863 is not priced separately by Part B.

8. Examples

Here are five examples of scenarios where HCPCS code G8863 may be used:

1. A patient visits a healthcare provider for a routine check-up, but no assessment for the risk of bone loss is conducted, and the reason for not conducting the assessment is not provided.
2. An elderly patient with a history of osteoporosis visits a specialist, but no assessment for the risk of bone loss is performed, and the reason for not conducting the assessment is not specified.
3. A patient presents with symptoms that could indicate a potential risk of bone loss, but no assessment is conducted, and the reason for not conducting the assessment is not documented.
4. A healthcare provider sees a patient who has recently undergone a bone density scan, but no further assessment for the risk of bone loss is conducted, and the reason for not conducting the assessment is not provided.
5. A patient with a family history of osteoporosis visits a healthcare provider, but no assessment for the risk of bone loss is performed, and the reason for not conducting the assessment is not specified.