How To Use HCPCS Code G6012

HCPCS code G6012 describes the radiation treatment delivery for three or more separate treatment areas, involving custom blocking, tangential ports, wedges, rotational beam, compensators, and electron beam with an energy range of 6-10 mev. This code is used to identify the specific procedure and services provided during radiation therapy.

1. What is HCPCS G6012?

HCPCS code G6012 is a specific code used in medical coding to identify the radiation treatment delivery procedure. It represents a comprehensive treatment plan that involves multiple treatment areas and various techniques to deliver radiation therapy to the patient.

2. Official Description

The official description of HCPCS code G6012 is “Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev.” The short description for this code is “Radiation treatment delivery.”

3. Procedure

1. The radiation treatment delivery procedure begins with the identification of three or more separate treatment areas that require radiation therapy.
2. The healthcare provider then creates custom blocking, which involves the use of shielding materials to protect healthy tissues and organs from radiation exposure.
3. Tangential ports are used to precisely target the radiation beams to the treatment areas.
4. Wedges may be utilized to modify the intensity of the radiation beams and ensure an even distribution of radiation dosage.
5. A rotational beam technique may be employed to deliver radiation from different angles, further enhancing treatment precision.
6. Compensators are used to adjust the radiation dose based on the patient’s anatomy and treatment requirements.
7. Finally, an electron beam with an energy range of 6-10 mev is utilized to deliver the radiation therapy.

4. When to use HCPCS code G6012

HCPCS code G6012 should be used when a healthcare provider performs radiation treatment delivery involving three or more separate treatment areas. This code is specifically applicable when custom blocking, tangential ports, wedges, rotational beam, compensators, and electron beam with an energy range of 6-10 mev are utilized during the procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G6012, healthcare providers need to ensure proper documentation of the procedure and the specific techniques used during radiation treatment delivery. This includes detailed information on the number of treatment areas, custom blocking materials, tangential ports, wedges, rotational beam angles, compensator adjustments, and the energy range of the electron beam. The documentation should support the medical necessity and appropriateness of the procedure.

6. Historical Information and Code Maintenance

HCPCS code G6012 was added to the Healthcare Common Procedure Coding System on January 01, 2015. Since its addition, 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 pricing of HCPCS code G6012 may vary depending on the insurance provider. Medicare considers this code as a carrier judgment, meaning the coverage determination is made by the insurance carrier. The pricing indicator code 13 indicates that the price for this code is established by carriers. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of scenarios where HCPCS code G6012 should be billed:

1. A patient with multiple separate tumor sites requiring radiation treatment delivery using custom blocking, tangential ports, wedges, rotational beam, compensators, and an electron beam with an energy range of 6-10 mev.
2. A patient with a complex case of cancer involving three distinct treatment areas, necessitating the use of advanced radiation techniques such as rotational beam and compensators.
3. A patient with a recurrent tumor in multiple locations, requiring radiation treatment delivery with custom blocking, tangential ports, and wedges.
4. A patient with a large tumor in a critical area, necessitating the use of custom blocking and compensators to protect nearby organs and deliver precise radiation dosage.
5. A patient with a rare form of cancer that requires radiation treatment delivery to multiple treatment areas using a combination of tangential ports, wedges, and an electron beam.