| Specialty
Groups — Oncology
HCPCS code G0175 In certain situations it is possible for a hospital to bill
HCPCS code G0175, which is defined as “scheduled interdisciplinary team
conference (minimum of three exclusive of patient care nursing staff) with
patient present.” According to Chapter II of the OPPS Manual:
“Hospitals can use HCPCS code G0175 in reporting a scheduled medical
conference with the patient involving a combination of at least three
health care professionals, and one of whom is a physician, but cannot be a
nurse.” The Medicare Intermediary Manual further discusses a
multidisciplinary approach to rehabilitation and states that the
multidisciplinary team in this venue is comprised of the physician,
rehabilitation therapists, psychologist and/or social worker, and
rehabilitation nurse(s). Therefore, the key requirements for billing this service
include: There must be at least 3 members of the multidisciplinary
staff present at the meeting, and One of these individuals must be a physician, and None of these three individuals can be a nurse (nurses may be
present in addition to the other members of the multidisciplinary team,
but at least 3 team members must represent disciplines other than
nursing), and The patient must also be present for the interdisciplinary
conference. Based upon the requirement that the patient must be
physically present during the team conference, hospitals should make
certain that HCPCS code G0175 is not assigned for tumor board meetings or
other staff conferences that do not include the patient. Reprinted with permission from the Journal of Oncology Management Jan/Feb issue. Cindy
C. Parman, CPC, CPC-H
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