G8854 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)
Billable / valid for submission HCPCS Release 2026Q3
Short description: Reas no adhere therapy
Version history
| Release | Valid from | Valid to | Description | Billable |
|---|---|---|---|---|
| 2026Q3 | 2026-07-01 | current | 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) | yes |
Related codes in G88
- G8806 Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented
- G8807 Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has a documented intrauterine pregnancy [iup])
- G8808 Trans-abdominal or trans-vaginal ultrasound not performed, reason not given
- G8815 Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
- G8816 Statin medication prescribed at discharge
- G8817 Statin therapy not prescribed at discharge, reason not given
- G8826 Patient discharged to home no later than post-operative day #2 following evar
- G8833 Patient not discharged to home by post-operative day #2 following evar
- G8834 Patient discharged to home no later than post-operative day #2 following cea
- G8838 Patient not discharged to home by post-operative day #2 following cea
- G8839 Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness
- G8840 Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)
- G8841 Sleep apnea symptoms not assessed, reason not given
- G8842 Apnea hypopnea index (ahi), respiratory disturbance index (rdi) or respiratory event index (rei) documented or measured within 2 months after initial evaluation for suspected obstructive sleep apnea
- G8843 Documentation of reason(s) for not measuring an apnea hypopnea index (ahi), a respiratory disturbance index (rdi), or a respiratory event index (rei) within 2 months after initial evaluation for suspected obstructive sleep apnea (e.g., medical, neurological, or psychiatric disease that prohibits successful completion of a sleep study, patients for whom a sleep study would present a bigger risk than benefit or would pose an undue burden, dementia, patients previously diagnosed with osa and severity assessed by another provider, patients who decline ahi/rdi/rei measurement, patients who had a financial reason for not completing testing, test was ordered but not completed, patients decline because their insurance (payer) does not cover the expense)
- G8844 Apnea hypopnea index (ahi), respiratory disturbance index (rdi), or respiratory event index (rei) not documented or measured within 2 months after initial evaluation for suspected obstructive sleep apnea, reason not given
- G8845 Positive airway pressure therapy prescribed
- G8846 Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)
- G8849 Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)
- G8850 Positive airway pressure therapy not prescribed, reason not given