Showing codes G9036 (Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)) — G9078 (Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project))
G9036 - Rimantadine hcl, brand
Long description: Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)
Code added date: 20041201.
Code effective date: 20200101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9037 - Intrpro req fr rec phys/qhcp
Long description: Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified health care professional for the care of the patient (i.e. not for professional education or scheduling) and may include subsequent follow up on the specialist's recommendations; 30 minutes
Code added date: 20240701.
Code effective date: 20240701.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9038 - Co-management services
Long description: Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care planning; condition for which specialist is taking a co-management role; condition expected to last at least 3 months; comprehensive care plan established, implemented, revised or monitored in partnership with co-managing clinicians; ongoing communication and care coordination between co-managing clinicians furnishing care
Code added date: 20240701.
Code effective date: 20240701.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9050 - Oncology work-up evaluation
Long description: Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9051 - Oncology tx decision-mgmt
Long description: Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9052 - Onc surveillance for disease
Long description: Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9053 - Onc expectant management pt
Long description: Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9054 - Onc supervision palliative
Long description: Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9055 - Onc visit unspecified nos
Long description: Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9056 - Onc prac mgmt adheres guide
Long description: Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9057 - Onc pract mgmt differs trial
Long description: Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9058 - Onc prac mgmt disagree w/gui
Long description: Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9059 - Onc prac mgmt pt opt alterna
Long description: Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9060 - Onc prac mgmt dif pt comorb
Long description: Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9061 - Onc prac cond noadd by guide
Long description: Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9062 - Onc prac guide differs nos
Long description: Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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G9063 - Onc dx nsclc stgi no progres
Long description: Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9064 - Onc dx nsclc stg2 no progres
Long description: Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9065 - Onc dx nsclc stg3a no progre
Long description: Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9066 - Onc dx nsclc stg3b-4 metasta
Long description: Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9067 - Onc dx nsclc dx unknown nos
Long description: Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9068 - Onc dx sclc/nsclc limited
Long description: Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9069 - Onc dx sclc/nsclc ext at dx
Long description: Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9070 - Onc dx sclc/nsclc ext unknwn
Long description: Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9071 - Onc dx brst stg1-2b hr,nopro
Long description: Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9072 - Onc dx brst stg1-2 noprogres
Long description: Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i, or stage iia-iib; or t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9073 - Onc dx brst stg3-hr, no pro
Long description: Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9074 - Onc dx brst stg3-noprogress
Long description: Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9075 - Onc dx brst metastic/ recur
Long description: Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9077 - Onc dx prostate t1no progres
Long description: Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t1-t2c and gleason 2-7 and psa < or equal to 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9078 - Onc dx prostate t2no progres
Long description: Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
Code added date: 20060101.
Code effective date: 20070101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML
PDF