How To Use HCPCS Code G8975

HCPCS code G8975 describes the documentation of medical reasons for a patient having a hemoglobin level less than 10 g/dl. This code is used to identify patients who have non-renal etiologies of anemia, such as sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection, or other medical reasons.

1. What is HCPCS G8975?

HCPCS code G8975 is a specific code used in medical coding to document the medical reasons for a patient having a hemoglobin level less than 10 g/dl. It is important for medical coders to accurately assign this code to ensure proper documentation and billing for the services provided.

2. Official Description

The official description of HCPCS code G8975 is “Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)." The short description of this code is "Hgb <10g/dl, med rsn."

3. Procedure

1. The healthcare provider should thoroughly evaluate the patient’s medical history and perform necessary diagnostic tests to determine the underlying cause of the low hemoglobin level.
2. Once the medical reasons for the low hemoglobin level have been identified, the provider should document these reasons in the patient’s medical record.
3. The documentation should include specific details about the non-renal etiologies of anemia or other medical reasons contributing to the low hemoglobin level.
4. The provider should ensure that the documentation is clear, concise, and supports the medical necessity for the services provided.

4. When to use HCPCS code G8975

HCPCS code G8975 should be used when documenting the medical reasons for a patient having a hemoglobin level less than 10 g/dl. It is important to use this code when the patient’s anemia is caused by non-renal etiologies or other medical reasons as specified in the official description.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G8975, healthcare providers should ensure that the documentation in the patient’s medical record supports the medical necessity for the services provided. The documentation should clearly state the medical reasons for the low hemoglobin level and provide specific details about the non-renal etiologies of anemia or other medical reasons contributing to the condition.

6. Historical Information and Code Maintenance

HCPCS code G8975 was added to the Healthcare Common Procedure Coding System on January 01, 2013. As of December 31, 2020, this code has been terminated. 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

The coverage for HCPCS code G8975 is determined by the carrier judgment. Medicare and other insurance providers may have specific guidelines and policies regarding the reimbursement for services associated with this code. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of when HCPCS code G8975 should be billed:

1. A patient with sickle cell anemia presenting with a hemoglobin level of 9 g/dl.
2. A patient with primary bone marrow disease experiencing a hemoglobin level of 8 g/dl.
3. A patient undergoing chemotherapy for the diagnosis of malignancy with a hemoglobin level of 7 g/dl.
4. A patient with postoperative bleeding resulting in a hemoglobin level of 6 g/dl.
5. A patient with an active bloodstream infection and a hemoglobin level of 9.5 g/dl.