Oncology & Hematology Coding Alert

Make sure to enter only 1 code for each assessment category Oncology offices participating in Medicare's 2005 demonstration project to measure quality of care for cancer patients undergoing chemotherapy will need to choose from a list of new G codes when reporting a patient's pain levels.
 
CMS spelled out how to use these new G codes in a November news release. "A participating practitioner will determine the patient's status by directly asking the patient about each of the three factors [nausea/vomiting, pain, lack of energy/fatigue], preferably at the start of each chemotherapy session. The resulting data will be used by the oncology practice to appropriately tailor treatments of the factors," CMS said.
 
Use the following G codes, new for 2005, in conjunction with your office's Rotterdam Symptom Checklist (RSCL) when reporting pain assessment levels in your chemo patients. (For an example of the Rotterdam checklist, see "Know How to Use the Rotterdam Symptom Checklist" on page 5.) G Codes for Nausea/Vomiting G9021 - Chemotherapy assessment for nausea and/or vomiting, patient-reported, performed at the time of chemotherapy administration; assessment level one: not at all (for use in a Medicare-approved demonstration project)
G9022 -  ... assessment level two: a little (for use in a Medicare-approved demonstration project)
G9023 -  ... assessment level three: quite a bit (for use in a Medicare-approved demonstration project)
G9024 -  ... assessment level four: very much (for use in a Medicare-approved demonstration project)
 
Example: On her RSCL, a chemotherapy patient circles level-two nausea. On the Medicare claim, you should report G9022 along with the appropriate code for chemo administration. G Codes for Pain G9025 - Chemotherapy assessment for pain, patient-reported, performed at the time of chemotherapy administration, assessment level one: not at all (for use in a Medicare-approved demonstration project)
G9026: -  ... assessment level two: a little (for use in a Medicare-approved demonstration project)
G9027 -  ... assessment level three: quite a bit (for use in a Medicare-approved demonstration project)
G9028 -  ... assessment level four: very much (for use in a Medicare-approved demonstration project)
 
Example: On her RSCL, a chemotherapy patient circles level-one pain. On the Medicare claim, you should report G9025 along with the appropriate code for chemo administration. G Codes for Lack of Energy (Fatigue) G9029 - Chemotherapy assessment for lack of energy (fatigue), patient-reported, performed at the time of chemotherapy administration, assessment level one: not at all (for use in a Medicare-approved demonstration project)
G9030 -  ... assessment level two: a little (for use in a Medicare-approved demonstration project)
G9031 -  ... assessment level three: quite a bit (for use in a Medicare-approved demonstration project)
G9032 -  ... assessment level four: very much (for use in a Medicare-approved demonstration project)
 
Example: On her RSCL, [...]