Summary & Overview

HCPCS G8545: Hepatitis C Measures Group Reporting Intent

HCPCS Level II code G8545 is a quality-reporting intent code used to indicate that a provider or organization plans to report the hepatitis C measures group. Such codes support national quality measurement programs by flagging participation in specific measure sets tied to hepatitis C screening, diagnosis, treatment, or follow-up. This designation matters nationally because standardized reporting enables assessment of care quality, performance comparisons across organizations, and alignment with payers’ value-based programs. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what G8545 represents, the clinical and administrative context for its use, and which major payers include or recognize such intent-reporting codes. The publication outlines typical service settings for this code, common reporting purposes, and where to look for policy guidance or measure specifications. It also summarizes benchmarking and reporting considerations relevant to quality programs and value-based arrangements. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG8545HCPCS Level IIhepatitis Cquality reportingmeasure reportingvalue-based carequality measuresoutpatient reporting

Billing Code Overview

HCPCS Level II code G8545 indicates an intent to report the hepatitis C measures group. The description, “I intend to report the hepatitis c measures group,” signals this code is used to communicate reporting of quality measures related to hepatitis C screening, diagnosis, treatment, or follow-up.

Service type: Quality measure reporting / quality measurement intent
Typical site of service: Administrative or reporting setting associated with outpatient, clinic, or population health quality reporting activities

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A primary care clinician or infectious disease specialist documents intent to report the hepatitis C measures group using billing code G8545. Typical workflow: a 48-year-old patient with a history of intravenous drug use presents for routine care. The clinician reviews prior hepatitis C screening and treatment history, orders HCV antibody and RNA testing as indicated, documents counseling and linkage-to-care plans, and records performance of quality measures (screening, confirmatory testing, initiation of direct-acting antiviral therapy, and follow-up viral load testing). The practice’s quality reporting staff compiles the results and submits the appropriate measure-group reporting via the electronic health record or registry tied to G8545 for payor quality programs.

Service Type: Quality measures reporting for hepatitis C care processes and outcomes.
Typical Site of Service: Ambulatory clinic (primary care or infectious disease clinic) and associated outpatient laboratory services.
Typical Patient Scenario: An adult with risk factors (history of injection drug use or elevated liver enzymes) seen in clinic; clinician documents screening, orders HCV antibody and confirmatory HCV RNA, provides education, refers to hepatology or starts direct-acting antiviral therapy when indicated, and schedules follow-up HCV RNA testing to document sustained virologic response.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service	Use when a distinct E/M visit is performed the same day as quality reporting activities and must be separately billed.
`59`	Distinct procedural service	Use to identify a service or procedure that is distinct or independent from other services performed on the same day when reporting procedures accompanying HCV care.
`24`	Unrelated E/M service by the same physician during a postoperative period	Use if an unrelated E/M visit occurs during a postoperative period for a patient previously treated for HCV-related procedures.
`27`	Multiple outpatient hospital E/M encounters on the same date	Use when multiple outpatient encounters occur on the same date requiring separate reporting.
`91`	Repeat clinical diagnostic laboratory test	Use when repeat HCV RNA testing is performed on the same day to confirm results.
`GA`	Waiver of liability statement on file (patient refuses)	Use when an advanced beneficiary notice or similar waiver is on file related to HCV services where applicable.
`KX`	Requirements specified in the medical policy have been met	Use when local medical policy criteria for HCV testing or treatment are met and need to be indicated for payor coverage.
`TC`	Technical component	Use when reporting only the technical component of a related diagnostic service (e.g., laboratory processing) separate from the professional component.
`26`	Professional component	Use when reporting only the professional component of a related diagnostic interpretation or consultation.
`XE`	Separate encounter, a service that is distinct because it occurred during a separate encounter	Use when services for HCV care occur during a separate encounter and must be distinguished.

Taxonomy Code	Specialty	Notes
`208D00000X`	Family Medicine	Primary care clinicians who screen and manage HCV and coordinate referral.
`207Q00000X`	Infectious Disease	Specialists who diagnose, stage, and manage antiviral therapy for HCV.
`207L00000X`	Gastroenterology	Hepatology-focused specialists involved in HCV treatment and liver disease management.
`363L00000X`	Clinical Laboratory	Laboratory personnel and organizations performing HCV antibody and RNA testing.
`164W00000X`	Public Health & General Preventive Medicine	Professionals involved in population-level HCV screening and linkage-to-care programs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B18.2`	Chronic viral hepatitis C	Primary diagnosis for patients with established chronic HCV infection receiving monitoring, treatment, or reporting.
`B19.20`	Unspecified viral hepatitis C without hepatic coma	Used when acute or unspecified HCV infection is documented and measures reporting applies.
`Z11.3`	Encounter for screening for infections with a predominantly sexual mode of transmission (used for hepatitis C screening encounters)	Used when documenting screening encounters for HCV in asymptomatic individuals.
`Z22.51`	Carrier of hepatitis C	Used to indicate patient carrier status relevant to public health reporting and care coordination.
`K76.9`	Liver disease, unspecified	Used when liver disease is suspected or documented in the context of HCV evaluation and management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80074`	Hepatitis C antibody, quantitative (HCV antibody)	Initial screening test commonly ordered as part of HCV measures reporting.
`87522`	Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C virus, amplified probe technique	Confirmatory HCV RNA testing used to document active infection and guide treatment.
`87636`	Infectious agent detection by nucleic acid (DNA or RNA), multiple types/targets (e.g., HCV genotyping panel if applicable)`	HCV genotyping may be performed to guide antiviral selection in some clinical workflows.
`99406`	Smoking and tobacco use cessation counseling, intermediate, 3-10 minutes	Counseling services often provided during HCV care visits; billed alongside E/M when appropriate.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Typical E/M code used for visits that include HCV screening, counseling, and care coordination.