G8854 HCPCS - 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 Information

HCPCS Code: G8854
Sequence Number: 0010
Short Description: 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)
Date Added: 1/1/2012
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2024
Classification: Temporary Procedures & Professional Services
Coding System: HCPCS

Berenson-Eggers Type Of Service Code: M5B - Specialist - psychiatry
Type Of Service Code:
- 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Pricing Indicator Code:
- 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
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')
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	G8854
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS 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)
HCPCS Short Description	Reas no adhere therapy
HCPCS Pricing Indicator Code 1	00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
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 Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	M5B - Specialist - psychiatry
HCPCS Type Of Service Code 1	1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2012
HCPCS Action Effective Date	1/1/2024
HCPCS Action Code	N - No maintenance for this code