Summary & Overview
HCPCS G8976: Hemoglobin Level ≥ 10 g/dl
HCPCS Level II code G8976 denotes that a patient's most recent hemoglobin (hgb) level is ≥ 10 g/dl. This code captures a discrete laboratory result used in clinical documentation and quality reporting, particularly relevant to chronic disease management such as anemia monitoring and patients receiving renal care. Nationally, standardized reporting of hemoglobin thresholds supports care coordination, quality measurement, and payer adjudication when labs and clinical outcomes are part of coverage determinations.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical intent, the most common sites where it is used (outpatient clinics, dialysis centers, and physician offices), and what documentation the code represents. The publication outlines typical use cases for hemoglobin result reporting, explains where this code fits in clinical workflows and quality programs, and identifies common modifiers associated with service reporting when available. Where input data is not provided, the publication states that the data is not available in the input. The content is intended for national audiences including billing professionals, clinical staff, and policy analysts seeking clarity on the meaning and application of HCPCS Level II code G8976.
Billing Code Overview
HCPCS Level II code G8976 indicates that a patient's most recent hemoglobin (hgb) level is greater than or equal to 10 g/dl. This code documents a laboratory-derived clinical measurement and is used to report the result status of hemoglobin testing.
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Service type: Laboratory result documentation of hemoglobin level
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Typical site of service: Outpatient clinics, dialysis centers, physician offices, and other ambulatory settings where hemoglobin testing and documentation occur
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with end-stage renal disease receiving maintenance hemodialysis presents for a monthly dialysis adequacy and anemia management visit. The dialysis facility documents the most recent hemoglobin result obtained from the facility laboratory 2 days prior. The hemoglobin is reported as 10.5 g/dL, meeting the performance threshold for the quality measure tied to billing code G8976 (Most recent hemoglobin (hgb) level >= 10 g/dl). Clinical workflow: the dialysis nurse or lab technician draws the monthly CBC during the dialysis session or from a pre-dialysis blood draw, the laboratory posts results to the EHR, the dialysis nurse or medical director reviews the value, and the facility records the measure in the quality reporting/case mix documentation to support billing and clinical quality reporting. Documentation includes patient identifiers, date/time of blood draw, specimen source, hemoglobin value with units (g/dL), and the date the result was reviewed by clinical staff.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when additional work beyond typical services is documented (rarely used with quality measure codes). |
23 |