How To Use HCPCS Code G8953

HCPCS code G8953 describes the performance of all quality actions for the applicable measures in the oncology measures group for a specific patient. This code is used to indicate that the necessary quality actions have been completed in the field of oncology. In this article, we will explore the details of HCPCS code G8953, 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 G8953?

HCPCS code G8953 is used to identify the completion of all quality actions for the applicable measures in the oncology measures group for a specific patient. It signifies that the necessary actions have been performed to ensure the quality of care in the field of oncology.

2. Official Description

The official description of HCPCS code G8953 is “All quality actions for the applicable measures in the oncology measures group have been performed for this patient.” The short description for this code is “Oncology mg qual act perform.”

3. Procedure

1. The provider must first identify the applicable measures in the oncology measures group for the patient.
2. They must then perform all the necessary quality actions related to these measures.
3. The provider should document the completion of these quality actions in the patient’s medical record.

4. When to use HCPCS code G8953

HCPCS code G8953 should be used when all the quality actions for the applicable measures in the oncology measures group have been performed for a specific patient. It indicates that the necessary steps have been taken to ensure the quality of care in the field of oncology for that patient.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8953, healthcare providers must ensure that they have documented the completion of all quality actions for the applicable measures in the oncology measures group in the patient’s medical record. This documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G8953 was added to the Healthcare Common Procedure Coding System on January 1, 2013. It has an action code of N, indicating that there is no maintenance for this code. This code was terminated on December 31, 2016. The termination of this code means that it is no longer valid for use in medical coding and billing.

7. Medicare and Insurance Coverage

HCPCS code G8953 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means that the value for this code is not established or it is not applicable for separate pricing by Part B.

8. Examples

Here are five examples of when HCPCS code G8953 should be billed:

1. A patient with a diagnosis of breast cancer has undergone all the necessary quality actions, including screenings, biopsies, and treatment, as recommended by the oncology measures group.
2. A patient with lung cancer has completed all the required quality actions, such as imaging studies, chemotherapy, and radiation therapy, as specified by the oncology measures group.
3. An individual with prostate cancer has undergone all the recommended quality actions, including prostate-specific antigen (PSA) testing, biopsies, and surgical interventions, as outlined by the oncology measures group.
4. A patient with colorectal cancer has completed all the necessary quality actions, including colonoscopies, surgical procedures, and adjuvant therapies, as indicated by the oncology measures group.
5. An individual with leukemia has undergone all the required quality actions, such as bone marrow biopsies, chemotherapy regimens, and stem cell transplants, as specified by the oncology measures group.