Oncology Coding Article-HCPCS Level II Codes

Specialty Groups — Oncology

Medical Oncology Code Changes

Stereotactic radiosurgery treatment planning and delivery is constantly changing as new equipment and techniques are employed in cancer therapy. To accommodate technological changes in treatment planning and delivery, new HCPCS Level II codes have been implemented for 2004:

G0338 – Linear accelerator-based stereotactic radiosurgery plan, including dose volume histograms for target and other critical structure tolerances, plan optimization performed for highly conformal distributions, plan positional accuracy and dose verification, all lesions treated, per course of treatment

  • This code was created by CMS to distinguish a stereotactic plan created for linear accelerator treatment from a plan used for GammaKnife (G0242) therapy.

G0339 – Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session, or first session of fractionated treatment 

G0340 – Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment

  • According to the Federal Register, November 7, 2003: “To further clarify, when providers perform multi-session image-guided robotic SRS therapy, they should bill using HCPCS code G0339 for the first session. For each additional session subsequent to the first session, providers should bill using only HCPCS code G0340 up to a maximum of five sessions.”

  • If the planned course of therapy will encompass more than five treatment sessions, the CPT


    procedure codes for treatment delivery should be assigned for all treatments delivered (77401-77416).

Cindy C. Parman, CPC, CPC-Hcparman-4485782
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.