2025 HCPCS Code 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)

TAGS: adherence reporting decline return patients disease unable documentation diagnosed insurance therapy terminal expected objectively advanced least cover
Short DescriptionReas no adhere therapy
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2012
HCPCS Action Effective Date January 01, 2024
HCPCS Pricing Indicator Code 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Type Of Service Code 1 - Medical care
HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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