Question 1

What is HCPCS code G8458?

Accepted Answer

HCPCS code G8458 is "Pt inelig geno no antvir tx". Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)

Question 2

What category is G8458 in?

Accepted Answer

G8458 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G8458?

Accepted Answer

Use G8458 when billing for pt inelig geno no antvir tx. 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 G8458 covered by Medicare?

Accepted Answer

Coverage for G8458 (Pt inelig geno no antvir tx) 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 G8458?

Accepted Answer

Documentation for G8458 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).