G8868 – Patients receiving a first course of anti-tnf therapy

Long description

Patients receiving a first course of anti-tnf therapy

Short description

1st course antitnf

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

M5B Specialist - psychiatry

Added

January 1, 2012

Last change

January 1, 2017 – No change

Termination date

December 31, 2016

Nearby G codes

• G8860 – Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
• G8861 – 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
• G8862 – Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
• G8863 – Patients not assessed for risk of bone loss, reason not given
• G8864 – Pneumococcal vaccine administered or previously received
• G8865 – Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
• G8866 – Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
• G8867 – Pneumococcal vaccine not administered or previously received, reason not given
• G8869 – Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
• G8870 – Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
• G8871 – Patient not receiving a first course of anti-tnf therapy
• G8872 – Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
• G8873 – 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)
• G8874 – Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
• G8875 – Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
• G8876 – 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)