Oncology Coding Article – HCPCS Level II G Codes

Specialty Groups — Oncology

HCPCS Level II G codes

The new year has brought a wealth of new HCPCS Level II G codes, including three (3) new codes for bone marrow and stem cell services.

G0265 describes cryopreservation, freezing and storage of cells for therapeutic use, each cell line, while G0266 is used to report thawing and expansion of frozen cells for therapeutic use (each aliquot). Last, code G0267 defines bone marrow or peripheral stem cell harvest, modification or treatment to eliminate cell types (such as T cells, metastatic carcinoma, etc.). CMS has indicated that they have developed these G codes to track utilization of these specified services, and will price G0265 and G0266 at the same allowance as 88240 and 88241 (which have similar definitions), respectively.

Medicare has also expressed concern regarding the use of CPT codes 38210-38215 (new for 2003), indicating that it is unclear whether any physician work is required to perform these stem cell services. CMS indicates that the descriptions of typical physician involvement in these procedures indicate that a significant portion of the physician work is procedure oversight or quality management services, which are not separately payable by Medicare. As a result, HCPCS code G0267 will also be reimbursed by CMS under the laboratory fee schedule at the same rate as deleted CPT code 86915.

Reprinted with permission from the Journal of Oncology Management March/April issue. 

Cindy C. Parman, CPC, CPC-Hcparman-8391380
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.