2025 HCPCS code G9130
(Deleted) Effective Date: N/A Deletion Date: N/A Procedures / Professional Services - Medicare Demonstration Projects G Codes Feed
Oncology - Other
Medical necessity in this context was determined by the demonstration project's criteria. The related CPT codes reported alongside G9130 would reflect the medical necessity of the services provided.
Hematology and oncology specialists participating in the Medicare demonstration project were responsible for reporting this code along with other required CPT codes. The project guidelines specified the reporting requirements for participating physicians.
In simple words: This code was part of a special program to track and understand multiple myeloma treatments better. It was only used in 2006 for specific Medicare patients and doctors participating in the program.
This code was used in a 2006 Medicare demonstration project related to multiple myeloma. It was reported alongside CPT codes to specify the primary focus of the visit, disease status, and adherence to guidelines.The project was limited to hematology/oncology specialists treating Medicare beneficiaries (excluding Medicare Advantage) between January 1, 2006, and December 31, 2006.
Example 1: A hematologist/oncologist saw a Medicare patient with multiple myeloma in February 2006. They reported G9130 with the appropriate CPT codes indicating the focus of the visit, disease status, and adherence to treatment guidelines as part of the demonstration project., A patient diagnosed with multiple myeloma in 2005 visited their oncologist, a participant in the demonstration project, for follow-up in March 2006. The oncologist used G9130 and related CPT codes to document the encounter according to the project requirements., A patient newly diagnosed with multiple myeloma in May 2006 consulted a hematologist participating in the Medicare demonstration project. The physician used G9130 in conjunction with CPT codes to record information about the visit, disease stage, and treatment plan adherence, as required by the project.
Documentation should include details supporting the primary focus of the visit, the current disease status of the multiple myeloma, and the adherence to established treatment guidelines. As the code was part of a demonstration project, adherence to specific project documentation protocols would have been necessary.
** G9130 is a deleted code and is no longer in use.It was specific to a limited-time Medicare demonstration project.Current coding for multiple myeloma involves ICD-10-CM codes (e.g., C90.00) and appropriate CPT codes for evaluation and management, chemotherapy administration, and other services provided.
- Specialties:Hematology, Oncology
- Place of Service:Office