• 30 MAY 15

    2015 CMS RADIATION ONCOLOGY FINAL RULE

    New Radiation Oncology Codes for CY 2015

    On August 28, 2014, the American Medical Association (AMA) released 2015 CPT Code changes, including certain changes pertaining to radiation oncology. Some of these new 2015 CPT code changes and values will take effect in 2015. On October 31, 2014, CMS (Centers for Medicare and Medicaid Services) decided not to finalize its decision to remove the radiation treatment vault as a direct expense when valuing radiation therapy services. While reconsidering whether or not the vault is a direct or indirect cost, CMS will not recognize some of the new CPT codes. Instead, new G-codes were created in place of CPT codes to continue current payment rates for CY 2015.

    As a result, these radiation oncology procedures will have interim G-codes established for 2015. This will allow practitioners to continue to report services to CMS in CY 2015 as they did in CY 2014, and for payments to be made the same way. All payment policies applicable to the CY 2014 CPT codes will apply to the replacement G-codes.
    In order for providers in the non-facility setting to bill all carriers uniformly, it is important that non-federal payors adopt these G-codes for 2015 for physician office claims.

    NOTE: this may be an issue since we have no guarantee that Commercial payors will recognize the new “G” codes.


    Radiation Therapy CMS Replacement Codes

    2014 Codes

    Description

    2015 Codes (Pro)

    2015 Tech (Freestanding)

    2015 Global (Freestanding)

    2015 Codes OPPS (Hospital)

    0073T

    IMRT compensator tx

    N/A

    G6016

    G6016

    77385

    0197T

    Intrafraction track motion

    N/A

    G6017

    G6017

    Deleted

    76950

    Echo guidance radiotherapy

    G6001-26

    G6001-TC

    G6001

    Deleted

    77014

    Ct scan for therapy guide

    77014-26

    77014-TC

    77014

    77387

    77305

    Teletherapy isodose plan simple

    77306-26

    77306-TC

    77306

    77306

    77310

    Teletherapy isodose plan intermediate

    Deleted

    Deleted

    Deleted

    Deleted

    77315

    Teletherapy isodose plan complex

    77307-26

    77307-TC

    77307

    77307

    77326

    Brachytherapy isodose plan; simple

    77316-26

    77316-TC

    77316

    77316

    77327

    Brachytherapy isodose plan; intermediate

    77317-26

    77317-TC

    77317

    77317

    77328

    Brachytherapy isodose plan; complex

    77318-26

    77318-TC

    77318

    77318

    77402

    Radiation tx >1 MEV; simple

    N/A

    G6003

    G6003

    77402

    77403

    Radiation tx >1 MEV; simple

    N/A

    G6004

    G6004

    77402

    77404

    Radiation tx >1 MEV; simple

    N/A

    G6005

    G6005

    77402

    77406

    Radiation tx >1 MEV; simple

    N/A

    G6006

    G6006

    77402

    77407

    Radiation tx >1 MEV; intermediate

    N/A

    G6007

    G6007

    77407

    77408

    Radiation tx >1 MEV; intermediate

    N/A

    G6008

    G6008

    77407

    77409

    Radiation tx >1 MEV; intermediate

    N/A

    G6009

    G6009

    77407

    77411

    Radiation tx >1 MEV; intermediate

    N/A

    G6010

    G6010

    77407

    77412

    Radiation tx >1 MEV; complex

    N/A

    G6011

    G6011

    774012

    77413

    Radiation tx >1 MEV; complex

    N/A

    G6012

    G6012

    774012

    77414

    Radiation tx >1 MEV; complex

    N/A

    G6013

    G6013

    77412

    77416

    Radiation tx >1 MEV; complex

    N/A

    G6014

    G6014

    77412

    77418

    IMRT radiation tx (simple)

    N/A

    G6015

    G6015

    77385

    77418

    IMRT radiation tx (complex)

    N/A

    G6015

    G6015

    77386

    77421

    Stereoscopic x-ray guidance

    G6002-26

    G6002-TC

    G6002

    Deleted

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