G8928 HCPCS - ADJUVANT CHEMOTHERAPY NOT PRESCRIBED OR PREVIOUSLY RECEIVED, FOR DOCUMENTED REASONS (E.G., MEDICAL CO-MORBIDITIES, DIAGNOSIS DATE MORE THAN 5 YEARS PRIOR TO THE CURRENT VISIT DATE, PATIENT'S DIAGNOSIS DATE IS WITHIN 120 DAYS OF THE END OF THE 12 MONTH REPORTING PERIOD, PATIENT'S CANCER HAS METASTASIZED, MEDICAL CONTRAINDICATION/ALLERGY, POOR PERFORMANCE STATUS, OTHER MEDICAL REASONS, PATIENT REFUSAL, OTHER PATIENT REASONS, PATIENT IS CURRENTLY ENROLLED IN A CLINICAL TRIAL THAT PRECLUDES PRESCRIPTION OF CHEMOTHERAPY, OTHER SYSTEM REASONS)

Code Information

HCPCS Code: G8928
Sequence Number: 0010
Short Description: Adj chem not pres rsn spec
Long Description: Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
Date Added: 1/1/2013
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2017
Classification: Temporary Procedures & Professional Services
Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: M5B - Specialist - psychiatry
Type Of Service Code:
- 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

Pricing Indicator Code:
- 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code: 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

HCPCS Record

Field Name	Field Value
Healthcare Common Procedure Coding System Code	G8928
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
HCPCS Short Description	Adj chem not pres rsn spec
HCPCS Pricing Indicator Code 1	00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Multiple Pricing Indicator Code	9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	M5B - Specialist - psychiatry
HCPCS Type Of Service Code 1	1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2013
HCPCS Action Effective Date	1/1/2017
HCPCS Termination Date	12/31/2016
HCPCS Action Code	N - No maintenance for this code

Code Information

Code Type

Billing Information

HCPCS Record

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