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PQRS measure #395

Patricia Posted Tue 13th of January, 2015 12:01:40 PM

Any tips on how to document this ("Left pleural Abscess Aspiration: Squamous cell carcinoma-with cell block) in the report to qualify for G9418?

SuperCoder Answered Wed 14th of January, 2015 13:48:07 PM

Thanks for your question. Please allow additional time to research.

SuperCoder Answered Wed 14th of January, 2015 13:48:07 PM
Emailed Hitesh
SuperCoder Answered Thu 15th of January, 2015 09:50:55 AM

HCPCS code G9418 can be used to report primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as NSCLC-NOS with an explanation.

Code G9418 should be used to report PQRS measure # 395 through Registry or Claim reporting method.

HCPCS code G9418 can be reported once per date of service when physician addresses the patient’s pathology report specimens with a diagnosis of non- small cell lung cancer.

To report this HCPCS code and PQRS measure # 395, physician need to document:

1.Patient age: Patient’s age should be in the range 18-75 years on the date of encounter.

2.Diagnosis Code: The record should document the appropriate diagnosis code for lung cancer.

ICD-9-CM code: 162.3, 162.4, 162.5, 162.8, 162.9 OR
ICD-10-CM code: C34.00, C34.01, C34.02, C34.10, C34.11, C34.12, C34.2, C34.30, C34.31, C34.32, C34.80, C34.81, C34.82, C34.90, C34.91, C34.92

3.Procedure Code: Along with patient’s age and appropriate diagnosis code, the appropriate surgical pathology procedure code should also be documented in the report as 88305 or 88307.

If all the above mentioned reporting criteria are met, HCPCS code G9418 can be used to report primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as NSCLC-NOS with an explanation.

Thanks !!

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