G8975 HCPCS - 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)

Code Information

HCPCS Code: G8975
Sequence Number: 0010
Short Description: Hgb <10g/dl, med rsn
Long Description: 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)
Date Added: 1/1/2013
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2021
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	G8975
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 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)
HCPCS Short Description	Hgb <10g/dl, med rsn
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	1/1/2013
HCPCS Action Effective Date	1/1/2021
HCPCS Termination Date	12/31/2020
HCPCS Action Code	N - No maintenance for this code