Question 1

What is HCPCS code G8851?

Accepted Answer

HCPCS code G8851 is "Adhere tx assess at lst ann". Adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available, documented)

Question 2

What category is G8851 in?

Accepted Answer

G8851 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8851?

Accepted Answer

Use G8851 when billing for adhere tx assess at lst ann. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G8851 covered by Medicare?

Accepted Answer

Coverage for G8851 (Adhere tx assess at lst ann) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G8851?

Accepted Answer

Documentation for G8851 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).