G8868 — Patients receiving a first course of anti-tnf therapy
G8868 is a HCPCS Level II code for patients receiving a first course of anti-tnf therapy. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2016 and is not valid on new claims.
This code has been terminated
CMS terminated G8868 on December 31, 2016. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
The CMS record for G8868
- Long descriptor
- Patients receiving a first course of anti-tnf therapy
- Short descriptor
- 1st course antitnf
- Added
- January 1, 2012
- Terminated
- December 31, 2016
- BETOS
- M5B
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8868
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8868 is not quite right, the correct code is very often within a few positions of it.
- G8860Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysterminated
- G8861Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribedterminated
- G8862Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysterminated
- G8863Patients not assessed for risk of bone loss, reason not given
- G8864Pneumococcal vaccine administered or previously received
- G8865Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
- G8866Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
- G8867Pneumococcal vaccine not administered or previously received, reason not given
- G8869Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
- G8870Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapyterminated
- G8871Patient not receiving a first course of anti-tnf therapyterminated
- G8872Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesionterminated
- G8873Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)terminated
- G8874Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesionterminated
- G8875Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
- G8876Documentation 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)
Questions about G8868
What is HCPCS code G8868?
G8868 is a HCPCS Level II code for patients receiving a first course of anti-tnf therapy. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8868?
The CMS HCPCS file marks G8868 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
Is G8868 still valid?
No. G8868 was terminated on December 31, 2016 and should not be used on new claims.