HCPCS Code G8880

Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)

Procedures/Professional Services (Temporary Codes)

G8880 is a valid 2025 HCPCS code for Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change) or just “Sen lym p node biop not perf” for short, used in Medical care.

HCPCS Code Details - G8880

HCPCS Level II Code
Procedures/Professional Services (Temporary Codes)
HCPCS Code G8880
Description

Long description:
Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)

Short description:
Sen lym p node biop not perf

HCPCS Modifier1
HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
BETOS2 code M5B - Specialist - psychiatry
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2019
Date added Added Jan 01, 2012
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
“NU” identifies the hospital bed as new equipment

See also

  • HCPCS G8879 · Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer

  • HCPCS 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)

  • HCPCS 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)

  • HCPCS 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)

  • HCPCS 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)

  • HCPCS G8876 · Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)

  • HCPCS G9616 · Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)

  • HCPCS G9619 · Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)

  • HCPCS G8881 · Stage of breast cancer is greater than t1n0m0 or t2n0m0

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”