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Chemotherapy
Demonstration Project
In order to
identify and assess certain oncology services in an office-based
oncology practice that positively affect outcomes in the Medicare
population, CMS will initiate a one-year demonstration project for
calendar year 2005. The focus of this demonstration project (http://www.cms.hhs.gov/media/press/release.asp?Counter=1245)
will be on: |
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1) Minimization of nausea and vomiting |
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2) Pain control management |
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3) Reduction of fatigue |
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Practitioners
participating in the project must provide and document specific
services related to pain management and minimization of nausea and
vomiting, as well as the reduction of fatigue (based on the
Rotterdam scale. To facilitate collection of this data, there are
twelve (12) new G codes: |
| G9021 |
Chemotherapy assessment for nausea and/or vomiting, patient
reported, performed at the time of chemotherapy administration;
assessment level one: not at all |
| G9022 |
assessment level two: a little |
| G9023 |
assessment level three: quite a bit |
| G9024 |
assessment level four: very much |
| G9025 |
Chemotherapy
assessment for pain, patient reported, performed at the time of
chemotherapy administration, assessment level one: not at all |
| G9026 |
assessment level two: a little |
| G9027 |
assessment level two: a little |
| G9028 |
assessment level four: very much |
| G9029 |
Chemotherapy assessment for lack of energy (fatigue), patient
reported, performed at the time of chemotherapy administration,
assessment level one: not at all |
| G9030 |
assessment level two: a little |
| G9031 |
assessment level two: a little |
| G9032 |
assessment level four: very much |
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Participating
providers must report a G code for each patient status factor
(nausea/vomiting, pain, fatigue) on the claim to receive payment. In
addition, a patient chemotherapy encounter is defined as
chemotherapy administered through IV infusion or push, limited to
once per day. During the course of the demonstration, an additional
payment of $130 per encounter will be paid to participating
practitioners for submitted the patient assessment data. By
reporting the designated G codes, the practitioner self-enrolls in
the demonstration project. |
