How To Use HCPCS Code G9829

HCPCS code G9829 describes the administration of breast adjuvant chemotherapy. This code is used to identify the specific procedure of administering chemotherapy to patients with breast cancer as part of their treatment plan. In this article, we will explore the details of HCPCS code G9829, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS G9829?

HCPCS code G9829 is a specific code used to identify the administration of breast adjuvant chemotherapy. It is important to note that this code is only applicable for breast cancer patients who require chemotherapy as part of their treatment plan. The code G9829 should not be used for other types of chemotherapy or for patients without breast cancer.

2. Official Description

The official description of HCPCS code G9829 is “Breast adjuvant chemotherapy administered.” This description accurately reflects the purpose of this code, which is to identify the administration of chemotherapy specifically for breast cancer patients.

3. Procedure

1. The procedure of HCPCS code G9829 involves the administration of chemotherapy drugs to breast cancer patients. The specific drugs and dosages may vary depending on the patient’s individual treatment plan and medical condition.
2. The administration of chemotherapy is typically performed by a healthcare professional, such as an oncologist or a nurse, in a clinical setting, such as a hospital or an outpatient facility.
3. Prior to the administration of chemotherapy, the healthcare provider will assess the patient’s overall health and ensure that they are suitable candidates for the treatment.
4. The chemotherapy drugs are usually administered intravenously, either through a vein in the arm or through a central venous catheter.
5. The administration process may involve the use of specialized equipment, such as infusion pumps, to ensure accurate dosage and delivery of the chemotherapy drugs.
6. During the administration, the healthcare provider will closely monitor the patient for any adverse reactions or side effects and provide appropriate supportive care.
7. After the completion of the chemotherapy administration, the patient may be observed for a period of time to ensure their stability before being discharged.

4. When to use HCPCS code G9829

HCPCS code G9829 should be used when breast adjuvant chemotherapy is administered to patients with breast cancer. It is important to ensure that the patient meets the eligibility criteria for this specific treatment and that the administration is performed as part of their overall treatment plan.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9829, healthcare providers need to document the administration of breast adjuvant chemotherapy in the patient’s medical records. The documentation should include details such as the date of administration, the specific chemotherapy drugs used, the dosage, and any relevant supporting information.

It is also important to follow the billing guidelines set forth by Medicare or other insurance providers. Providers should submit accurate and complete claims, including the appropriate HCPCS code, along with any necessary supporting documentation.

6. Historical Information and Code Maintenance

HCPCS code G9829 was added to the Healthcare Common Procedure Coding System on January 01, 2017. As of December 31, 2020, this code has been terminated. The termination of a code indicates that it is no longer valid for use in medical billing and coding.

It is important for medical coders and billers to stay updated on code changes and revisions. In the case of HCPCS code G9829, it is no longer applicable for use after December 31, 2020, and alternative codes or procedures may need to be used for breast adjuvant chemotherapy administration.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G9829 by Medicare and other insurance providers may vary. It is important to consult the specific guidelines and policies of each insurance provider to determine the coverage and reimbursement for breast adjuvant chemotherapy administration.

The pricing indicator code for HCPCS code G9829 is 00, which indicates that the service is not separately priced by Part B. This means that the administration of breast adjuvant chemotherapy may be bundled or included in the overall reimbursement for other services or procedures.

8. Examples

Here are five examples of scenarios in which HCPCS code G9829 should be billed:

1. A 45-year-old female patient with stage II breast cancer receives her first cycle of adjuvant chemotherapy in an outpatient oncology clinic.
2. A 60-year-old male patient with metastatic breast cancer receives weekly adjuvant chemotherapy infusions in a hospital setting.
3. A 55-year-old female patient with recurrent breast cancer undergoes adjuvant chemotherapy following a mastectomy procedure.
4. A 70-year-old male patient with hormone receptor-positive breast cancer receives adjuvant chemotherapy in combination with targeted therapy.
5. A 50-year-old female patient with triple-negative breast cancer receives neoadjuvant chemotherapy prior to surgery.