AHA Coding Clinic® for HCPCS - 2014 Quarter 4; For Your Information
New HCPCS Level II G-codes for radiation therapy
The Centers for Medicare & Medicaid Services (CMS) recently established new HCPCS Level II G codes for use in calendar year (CY) 2015. These new HCPCS Level II G codes will be utilized to report radiation treatment delivery services. However, please note that the new HCPCS Level II G codes will be recognized under the Medicare Physician Fee Schedule (MPFS), but will not be recognized under the hospital Outpatient Prospective Payment System (OPPS). Under the OPPS facilities will continue to report radiation treatment delivery services with the appropriate CPT code(s). ...
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Article Overview
This article provides a brief CMS-focused update for coding and reimbursement professionals working with radiation therapy services. It covers the introduction of new HCPCS Level II G codes for calendar year 2015 and discusses how these codes are treated under Medicare payment systems compared with CPT reporting in the hospital outpatient setting. The piece is relevant to billers, coders, and facility staff who need to understand which code set applies in different settings.
Why This Topic Matters
Changes to Medicare reporting for radiation treatment delivery services can affect claim submission and code-set selection across physician and facility environments. Understanding the update helps readers identify when HCPCS Level II or CPT is involved under the stated payment systems.
What You Will Learn
- What CMS updated for calendar year 2015
- How the update relates to radiation treatment delivery services
- How reporting differs between Medicare payment environments
- Which code set is referenced for hospital outpatient reporting
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Radiation oncology practices
- Hospital outpatient departments
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