How To Use HCPCS Code G6015

HCPCS code G6015 describes the intensity modulated treatment delivery using narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session. This code is used for radiation therapy delivery using intensity-modulated radiation therapy (IMRT) techniques. In this article, we will explore the details of HCPCS code G6015, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G6015?

HCPCS code G6015 is used to identify the intensity modulated treatment delivery using narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session. This code specifically refers to the delivery of radiation therapy using IMRT techniques.

2. Official Description

The official description of HCPCS code G6015 is “Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session.” The short description for this code is “Radiation tx delivery imrt.”

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the appropriate treatment plan.
2. The treatment session starts with the patient being positioned on the treatment table.
3. The radiation therapy machine, equipped with narrow spatially and temporally modulated beams, is positioned to deliver the radiation to the targeted area.
4. The machine utilizes binary and dynamic multileaf collimators (MLC) to shape the radiation beams and modulate their intensity.
5. The provider ensures that the treatment is delivered accurately and precisely, adjusting the machine settings as necessary.
6. After the treatment session is complete, the patient is removed from the treatment table.

4. When to use HCPCS code G6015

HCPCS code G6015 should be used when a healthcare provider delivers radiation therapy using intensity-modulated techniques. This code is specifically for the delivery of IMRT treatment sessions using narrow spatially and temporally modulated beams and binary, dynamic MLC.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G6015, healthcare providers should ensure that the following documentation is included:

• Medical records supporting the need for radiation therapy and the use of IMRT techniques
• Documentation of the treatment session, including the number of fields/arcs used and the specific parameters of the treatment
• Any additional documentation required by the payer or insurance company

6. Historical Information and Code Maintenance

HCPCS code G6015 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 of HCPCS code G6015 may vary depending on the payer and insurance company. Medicare considers this code as a carrier judgment, meaning the coverage determination is made by the individual carrier. It is important for healthcare providers to check with the specific payer or insurance company for their coverage policies and guidelines.

8. Examples

Here are five examples of when HCPCS code G6015 should be billed:

1. A patient with prostate cancer receiving IMRT treatment sessions using narrow spatially and temporally modulated beams and binary, dynamic MLC.
2. A patient with head and neck cancer undergoing radiation therapy with IMRT techniques.
3. A patient with breast cancer receiving radiation therapy using IMRT to target the tumor site.
4. A patient with lung cancer undergoing IMRT treatment sessions to deliver radiation to the affected area.
5. A patient with brain tumor receiving radiation therapy using IMRT techniques.