2015 Coding For Radiation Oncology

2015 Coding For Radiation Oncology

1/23/2015

We will accept the replacement radiation oncology G-codes. Our Plans follow guidance on this matter as set forth by the Centers for Medicare & Medicaid Services (CMS). In October 2014, CMS announced it would require new Healthcare Common Procedure Coding System (HCPCS) G-codes for radiation oncology in 2015. These codes replace 2014 Current Procedural Terminology (CPT) codes for radiation oncology. This change became effective Jan. 1, 2015.

This table lists the 2015 G-codes CMS created and the 2014 CPT codes they will replace:

 Radiation Oncology Replacement G-Codes for 2015

 2014 CPT

2015 HCPCS

Long Description

Short Description

 

 76950

 G6001

 Ultrasonic guidance for placement of radiation therapy fields

 Echo guidance radiotherapy

 

 77421

 G6002

 Stereoscopic X-ray guidance for localization of target volume for the delivery of radiation therapy

 Stereoscopic X-ray guidance

 

 77402

 G6003

 
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: up to 5mev

 
Radiation treatment delivery

 

 77403

 G6004

 
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, single blocks or no blocks: 6-10mev

Radiation treatment delivery

 77404

 G6005

 
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 11-19mev

 
Radiation treatment delivery

 

 77406

 G6006

 
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 20mev or greater

Radiation treatment delivery

 77407

 G6007

 
Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple blocks: up to 5mev

Radiation treatment delivery

 77408

 G6008

 
Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple blocks: 6-10mev

 
Radiation treatment delivery

 

 77409

 G6009

 
Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple blocks: 11-19mev

 
Radiation treatment delivery

 

 77411

 G6010

 
Radiation treatment delivery, two separate treatments areas, three or more ports on a single treatment area, use multiple blocks: 20mev or more

Radiation treatment delivery

 77412

 G6011

 
Radiation treatment delivery, three  or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5mev

 
Radiation treatment delivery

 

 77413

 G6012

 
Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10mev

 
Radiation treatment delivery

 

 77414

 G6013

 
Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19mev

 
Radiation treatment delivery

 

 77416

 G6014

 
Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20mev or greater

 
Radiation treatment delivery

 

 77418

 G6015

 
Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session

 
Radiation treatment delivery

 

 0073T

 G6016

 
Compensator-based beam modulation treatment delivery of inverse planned treatment using three or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session

Delivery comp imrt

 

 0197T

 G6017

 
Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment

Intrafraction track motion

 

 

Our Plans will not accept claims you file with the 2014 CPT codes. You will receive a reject notification on your remittance advice when you use these codes.

Reminder about Precertification
Effective Jan. 1, 2015, BlueCross BlueShield of South Carolina requires National Imaging Associates (NIA) precertification for many radiation oncology services when you perform and bill them in an outpatient or office location. NIA is an independent company that provides precertification services for certain imaging services on behalf of BlueCross and BlueChoice HealthPlan of South Carolina. To determine if a service requires precertification, review our precertification guide at www.SouthCarolinaBlues.com.

Additional information about CMS’ coding changes for radiation oncology is available at https://www.federalregister.gov/articles/2014/11/13/2014-26183/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-clinical-laboratory.

For more information about this bulletin, please contact Provider Education at 803-264-4730 or by email at provider.education@bcbssc.com.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.