Procedure Codes for SEER-Medicare Analyses
The table below contains codes for procedures that are frequently included in
SEER-Medicare analyses and are current as of March 2003. Investigators who wish to use
these codes are encouraged to refer to ICD-9, CPT-4, and HCPCS manuals, as codes change
over time.
Chemotherapy Codes
| |
ICD-9 Diagnoses |
ICD-9 Procedures |
HCPCS |
| Administration |
V58.1 |
99.25 |
964xx, 965xx,
Q0083-Q0085
51720 (bladder instillation) |
| Specific drugs |
n/a |
n/a |
Oral drugs:
J8510, J8520, J8521*
J8530-J8999**
IV: J9000-J9999 |
| Anti-emetics (if associated w/chemo) |
n/a |
n/a |
The types of anti-emetics available and covered by Medicare changes frequently. Investigators should consult the list of HCPCS. |
| Other |
V66.2, V67.2 |
|
|
* Medicare will cover certain oral anti-cancer drugs called Prodrugs. The drugs should be billed with codes J8510, J8520, J8521 (for services performed on or after January 1, 2000) or J8999.
** Claims for covered oral anti-cancer drugs will be processed under codes J8530-J8999 and appear in the DME file.
Radiation Therapy Codes
| |
ICD-9 Diagnoses |
ICD-9 Procedures |
Revenue Center Codes |
HCPCS codes |
| Administration |
V58.0, V66.1
V67.1 |
92.21 – 92.29 |
0330, 0333 |
77401-77499, 77520, 77523, 77750-77799, G0256, G0261 |
Codes Used to Identify Screening & Related Procedures in the Medicare Claims for Selected Cancers
| Type of test |
Screening Codes |
Diagnostic Codes |
| Mammogram |
76092 |
76090-unilateral, 76091-bilateral |
| Prostate specific antigen (PSA) |
G0103 |
86316 (prior to 1988)
84153 (1988 and later) |
| Digital rectal examination |
G0102 |
|
| Fecal Occult Blood Tests (FOBT) |
G0107 |
82270-82273 (pathology codes) |
| Sigmoidoscopy |
G0104 |
w/biopsy removal:
45305, 45308, 45309, 45315, 45320, 45331 |
| Colonoscopy |
G0105 (high risk)
G0121 (non-high risk) |
w/biopsy removal:
45380, 45384, 45385 |
| Double Contrast Barium Enema (DCBE) |
G0106, G0120, G0122 |
|
|
