HCPCS G8938
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
HCPCS
G8938
CMS Temporary Procedures & Professional Services
Description
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
Common Specialties
Internal Medicine, Emergency Medicine
Documentation Requirements
- Document clinical indications and clear medical necessity supporting the encounter or procedure.
- Ensure complete provider signatures, credentials, date, and specific place of service (POS).
- Verify documentation strictly supports code specificity to prevent downcoding or claim denials.
Billing & Coding Tips
- Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
- Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
- Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.
Related Codes
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