How To Use HCPCS Code G2208

HCPCS code G2208 describes a specific situation where a patient did not receive an adjuvant treatment course that includes both chemotherapy and her2-targeted therapy. This code is used to indicate that the patient did not undergo this specific treatment regimen.

1. What is HCPCS G2208?

HCPCS code G2208 is a specific code used in medical coding to identify cases where a patient did not receive adjuvant treatment that includes both chemotherapy and her2-targeted therapy. It is important to accurately assign this code to reflect the patient’s treatment history and ensure proper documentation and billing.

2. Official Description

The official description for HCPCS code G2208 is “Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy.” The short description for this code is “No trtmt chemo and her2.”

3. Procedure

1. When assigning HCPCS code G2208, the medical coder should review the patient’s medical records and treatment history.
2. If the patient did not receive a specific adjuvant treatment course that includes both chemotherapy and her2-targeted therapy, HCPCS code G2208 should be assigned.
3. It is important to accurately document the reasons why the patient did not receive this treatment course to support the use of HCPCS code G2208.

4. When to use HCPCS code G2208

HCPCS code G2208 should be used in cases where the patient did not receive adjuvant treatment that includes both chemotherapy and her2-targeted therapy. This code is specific to situations where this particular treatment course was not administered.

5. Billing Guidelines and Documentation Requirements

When billing for services or supplies related to HCPCS code G2208, healthcare providers should ensure proper documentation to support the use of this code. The medical records should clearly indicate that the patient did not receive the specified adjuvant treatment course. This documentation is crucial for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G2208 was added to the Healthcare Common Procedure Coding System on January 01, 2021. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage and reimbursement for HCPCS code G2208 may vary depending on the specific insurance provider. It is important to review the pricing indicator code and multiple pricing indicator code to understand how this service or supply is priced by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G2208 should be billed:

1. A patient with a specific medical condition did not meet the eligibility criteria for the adjuvant treatment course that includes both chemotherapy and her2-targeted therapy.
2. A patient refused to undergo the recommended adjuvant treatment course that includes both chemotherapy and her2-targeted therapy.
3. A patient experienced severe adverse reactions to previous chemotherapy and her2-targeted therapy, making it medically contraindicated to continue with the adjuvant treatment course.
4. A patient’s medical condition progressed rapidly, and the adjuvant treatment course that includes both chemotherapy and her2-targeted therapy was no longer considered beneficial.
5. A patient’s healthcare provider determined that an alternative treatment approach would be more suitable, and the adjuvant treatment course that includes both chemotherapy and her2-targeted therapy was not pursued.