HCPCS codes / G / G8854
G8854
Documentation of reason(s) for not objectively reporting adherence to evidence-based therapy (e.g., patients who have been diagnosed with a terminal or advanced disease with an expected life span of less than 6 months, patients who decline therapy, patients who do not return for follow-up at least annually, patients unable to access/afford therapy, patient's insurance will not cover therapy)
- Code type
- HCPCS Level II
- Coverage
- Carrier judgment
- BETOS category
- M5B
- Pricing indicator
- 00
- Effective date
- 20240101
Verify before billing. Confirm against current official CMS HCPCS files and your payer's rules before clinical or claims use.