In simple words: This code is used for cancer patients when the doctor's treatment plan is different from the usual guidelines, for reasons not covered by other codes. It helps Medicare track how different treatment approaches affect patient care.

This code is used within a Medicare demonstration project for hematology and oncology specialists. It signifies that the services provided to the cancer patient deviate from established practice guidelines, and the reason for this deviation isn't covered by other guideline adherence codes (G9056-G9061). It is reported alongside CPT codes indicating the primary focus of the visit, disease status, and guideline adherence. Applicable only to non-Medicare Advantage patients.

Example 1: A patient with breast cancer receives a chemotherapy regimen that is not the standard of care due to a specific genetic mutation. G9062 is reported to indicate this deviation., A patient with leukemia receives a lower dose of a standard chemotherapy drug due to pre-existing kidney disease. G9062 is reported because the treatment deviates from standard guidelines due to the patient's comorbidities., A patient with lymphoma undergoes a clinical trial treatment that is not yet considered standard practice. G9062 is reported to document this deviation.

Documentation must clearly explain the medical necessity of the deviation from practice guidelines, the specific reasons for the altered treatment approach, and the patient's condition necessitating this deviation.

** This code is part of a Medicare demonstration project, and its use may change or be discontinued based on the project's findings. It is vital to stay updated on the latest Medicare guidelines regarding this code.