Specialty Groups — Oncology
Medical Oncology Code Changes
ACOA Coding Minute
|
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: |
|
| 1) Minimization of nausea and vomiting | |
| 2) Pain control management | |
| 3) Reduction of fatigue | |
| 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 |
| 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. | |
Cindy C. Parman, CPC, CPC-H
principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy is a current member of the Advisory Board for the American Academy of Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a subsidiary of the American Medical Association. She serves as the Consulting Editor of the Radiology Coding Alert and is on the Editorial Advisory Board of General Surgery Coding Alert and Pain Management Coding Alert.