G9835 – Trastuzumab administered within 12 months of diagnosis

Long description

Trastuzumab administered within 12 months of diagnosis

Short description

Trastuz given w/in 12 mos dx

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2017

Last change

January 1, 2021 – No change

Termination date

December 31, 2020

Nearby G codes

• G9827 – Her2-targeted therapies not administered during the initial course of treatment
• G9828 – Her2-targeted therapies administered during the initial course of treatment
• G9829 – Breast adjuvant chemotherapy administered
• G9830 – Her-2/neu positive
• G9831 – Ajcc stage at breast cancer diagnosis = ii or iii
• G9832 – Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis = t1c
• G9833 – Patient transfer to practice after initiation of chemotherapy
• G9834 – Patient has metastatic disease at diagnosis
• G9836 – Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
• G9837 – Trastuzumab not administered within 12 months of diagnosis
• G9838 – Patient has metastatic disease at diagnosis
• G9839 – Anti-egfr monoclonal antibody therapy
• G9840 – Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab
• G9841 – Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab
• G9842 – Patient has metastatic disease at diagnosis
• G9843 – Ras (kras or nras) gene mutation