How To Use HCPCS Code G6011

HCPCS code G6011 describes the delivery of radiation treatment to three or more separate treatment areas using custom blocking, tangential ports, wedges, rotational beam, compensators, and electron beam with an energy level of up to 5 mev. This code is used to identify and bill for the specific procedure involved in radiation therapy.

1. What is HCPCS G6011?

HCPCS code G6011 is a specific code used in medical billing and coding to identify the delivery of radiation treatment to multiple treatment areas using various techniques and equipment. It is important to note that this code specifically refers to the procedure itself and not the overall process of radiation therapy.

2. Official Description

The official description of HCPCS code G6011 is “Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev.” The short description is “Radiation treatment delivery.”

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the need for radiation therapy.
2. A treatment plan is developed, specifying the areas that require radiation treatment.
3. The patient is positioned on the treatment table in the appropriate position for the delivery of radiation.
4. The provider uses custom blocking techniques to shield healthy tissues and organs from radiation exposure.
5. Tangential ports are used to precisely target the treatment areas.
6. Wedges may be used to further shape the radiation beam and ensure uniform dose distribution.
7. A rotational beam technique may be employed to deliver radiation from different angles.
8. Compensators are utilized to account for variations in tissue thickness and density.
9. If necessary, an electron beam with an energy level of up to 5 mev is used for treatment.
10. The radiation treatment is delivered according to the established treatment plan.

4. When to use HCPCS code G6011

HCPCS code G6011 should be used when a healthcare provider delivers radiation treatment to three or more separate treatment areas using the specified techniques and equipment. It is important to ensure that the procedure performed aligns with the official description of the code to accurately bill for the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G6011, healthcare providers should ensure that the necessary documentation is in place to support the procedure performed. This may include the treatment plan, details of the areas treated, and any specific techniques or equipment used. It is important to follow the billing guidelines set forth by the relevant insurance carriers and provide all required information to facilitate accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G6011 was added to the Healthcare Common Procedure Coding System on January 01, 2015. As of the provided knowledge, no maintenance actions have been taken for this code, indicating that it remains unchanged since its addition. It is important to stay updated with any changes or revisions to the code in order to accurately use it for billing purposes.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code G6011 may vary depending on the specific insurance carrier and Medicare guidelines. The pricing indicator code for this code is 13, which indicates that the price is established by carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology. Healthcare providers should consult the relevant insurance policies and Medicare guidelines to determine the coverage and reimbursement for this specific procedure.

8. Examples

Here are five examples of when HCPCS code G6011 may be billed:

1. A patient with multiple cancerous tumors in different areas of the body undergoes radiation treatment using custom blocking, tangential ports, wedges, rotational beam, compensators, and electron beam.
2. A patient with breast cancer receives radiation treatment to the breast, lymph nodes, and chest wall using the specified techniques and equipment.
3. A patient with head and neck cancer undergoes radiation treatment targeting multiple areas in the head and neck region, including the throat, tongue, and lymph nodes.
4. A patient with pelvic cancer receives radiation treatment to the pelvis, including the uterus, ovaries, and surrounding tissues, using the specified techniques and equipment.
5. A patient with multiple bone metastases undergoes radiation treatment to various bone sites using the specified techniques and equipment.