Showing codes G8850 (Positive airway pressure therapy not prescribed, reason not given) — G8880 (Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change))

G8850 - No pap prescribed
Long description: Positive airway pressure therapy not prescribed, reason not given
Code added date: 20120101.
Code effective date: 20130101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8851 - Adhere tx assess at lst ann
Long description: Adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available, documented)
Code added date: 20120101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8852 - Pos air press prescribe
Long description: Positive airway pressure therapy was prescribed
Code added date: 20120101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8853 - Pos air press not prescribe
Long description: Positive airway pressure therapy not prescribed
Code added date: 20120101.
Code effective date: 20170101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8854 - Reas no adhere therapy
Long description: 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 added date: 20120101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8855 - Ther not assessed annually
Long description: Adherence to therapy was not assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available), reason not given
Code added date: 20120101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8856 - Ref for oto eval
Long description: Referral to a physician for an otologic evaluation performed
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8857 - No elig ref for oto eval
Long description: Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8858 - Not ref for oto eval
Long description: Referral to a physician for an otologic evaluation not performed, reason not given
Code added date: 20120101.
Code effective date: 20130101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8859 - Corticosteroids 10mg 60 days
Long description: Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Code added date: 20120101.
Code effective date: 20150101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8860 - Corticosteroid 10 mg 60 days
Long description: Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Code added date: 20120101.
Code effective date: 20150101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8861 - Dxa ordered for osteo
Long description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
Code added date: 20120101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8862 - No corticostrd 10mg 60 days
Long description: Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Code added date: 20120101.
Code effective date: 20150101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8863 - No assess bone loss
Long description: Patients not assessed for risk of bone loss, reason not given
Code added date: 20120101.
Code effective date: 20130101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8864 - Pneumococcal vaccine admin
Long description: Pneumococcal vaccine administered or previously received
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8865 - Doc med reas no pneumococcal
Long description: Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8866 - Doc pt reas no pneumococcal
Long description: Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8867 - No pneumococcal admin
Long description: Pneumococcal vaccine not administered or previously received, reason not given
Code added date: 20120101.
Code effective date: 20130101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8868 - 1st course antitnf
Long description: Patients receiving a first course of anti-tnf therapy
Code added date: 20120101.
Code effective date: 20170101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8869 - Doc immune hep b antitnf
Long description: Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
Code added date: 20120101.
Code effective date: 20180101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8870 - Hepb admin 1st antitnf
Long description: Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
Code added date: 20120101.
Code effective date: 20160101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8871 - No 1st antitnf
Long description: Patient not receiving a first course of anti-tnf therapy
Code added date: 20120101.
Code effective date: 20160101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8872 - Intraop image confirm excise
Long description: Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
Code added date: 20120101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8873 - Specimen not intraop image
Long description: Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
Code added date: 20120101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8874 - Tissue not image intraop
Long description: Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
Code added date: 20120101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8875 - Breast cancer dx min invsive
Long description: Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8876 - Doc reas no min inv dx
Long description: Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)
Code added date: 20120101.
Code effective date: 20150101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8877 - No brst cncr dx min invasive
Long description: Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given
Code added date: 20120101.
Code effective date: 20130101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8878 - Sent lymph node biopsy
Long description: Sentinel lymph node biopsy procedure performed
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8879 - Node neg inv brst cncr
Long description: Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
Code added date: 20120101.
Code effective date: 20180101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G8880 - Sen lym p node biop not perf
Long description: Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)
Code added date: 20120101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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