In simple words: This code is used for a special Medicare project to track information about breast cancer treatment. It tells the doctor that a woman with breast cancer is in stage I or IIA to IIB, or T3, N1, M0, and her cancer cells don't respond to estrogen or progesterone. It also shows there are no signs of the cancer getting worse or spreading.

This code reports the current disease status of a patient’s invasive female breast cancer as part of a Medicare-approved demonstration project. The patient has invasive female breast cancer where the predominant cell type is adenocarcinoma. The cancer is Stage I or Stage IIA to IIB, or T3, N1, M0, and is estrogen and progesterone negative. There is no evidence of disease progression, recurrence, or metastasis. This code is not used for ductal carcinoma in situ.

Example 1: A 55-year-old female patient with Stage IIA invasive breast cancer, confirmed as adenocarcinoma, is seen for routine follow-up. The cancer is ER/PR negative, and there is no evidence of metastasis. The physician reports G9072 along with the appropriate CPT codes for the visit., A 60-year-old female patient with T3, N1, M0 invasive breast cancer, confirmed as adenocarcinoma, undergoes chemotherapy. The cancer is ER/PR negative, and there is no current evidence of disease progression. The physician reports G9072 with the appropriate CPT codes for the chemotherapy administration., A 48-year-old female with a history of Stage I invasive breast cancer (adenocarcinoma), ER/PR negative, is seen for a routine check-up. Imaging and physical exam show no signs of recurrence or metastasis. G9072 is reported, along with the appropriate E/M code.

Documentation should include the patient's stage of invasive breast cancer, confirmation of adenocarcinoma as the predominant cell type, ER/PR status, and the absence of disease progression, recurrence, or metastasis. Additionally, documentation must support the medical necessity of the visit or procedure performed.