Summary & Overview
HCPCS G8749: Absence of Signs or Symptoms of Systemic Spread of Melanoma
HCPCS Level II code G8749 denotes documentation that there are no signs or symptoms indicating systemic spread of melanoma, covering absence of findings such as tenderness, jaundice, focal neurologic deficits, cough, dyspnea, pain, or paresthesia. Nationally, clear documentation of disease extent affects care pathways, surveillance decisions, and staging-related communication across clinicians and payers. This code matters because it standardizes how clinicians record a negative systemic review specifically for melanoma, which can affect authorization, coding clarity, and downstream clinical decisions.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise policy and clinical context for G8749, outlining common use cases, where the code is typically reported (outpatient dermatology, oncology, or office-based examinations), and what stakeholders should expect when this assertion is present in the medical record.
Readers will learn the clinical intent of G8749, typical sites of service and service type, common documentation scenarios, and what data is available or missing for fee and policy benchmarking. Data not available in the input is noted explicitly. The piece focuses on descriptive and policy-relevant information for national audiences, without making clinical recommendations.
Billing Code Overview
HCPCS Level II code G8749 documents the absence of signs or symptoms suggesting systemic spread of melanoma. The code description specifies absence of signs such as tenderness, jaundice, localized neurologic deficits (for example, weakness), or any other sign suggesting systemic spread, and absence of symptoms such as cough, dyspnea, pain, paresthesia, or any other symptom suggesting possible systemic spread of melanoma.
Service type: Clinical assessment of melanoma for systemic signs and symptoms.
Typical site of service: Outpatient clinic, dermatology or oncology consultation, and office-based clinical examination.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with a history of cutaneous melanoma presents for routine surveillance after definitive treatment (wide local excision ± sentinel lymph node biopsy). The visit is performed in an outpatient dermatology or surgical oncology clinic or an outpatient hospital clinic. The clinician performs a focused history and physical exam to document the absence of signs or symptoms suggesting systemic spread of melanoma, specifically assessing for: skin or wound tenderness, jaundice, focal neurologic deficits (weakness, focal sensory loss), new cough or dyspnea, unexplained pain, paresthesia, or constitutional symptoms. Documentation includes review of systems, vital signs, targeted neurologic and pulmonary exam, and comparison to prior notes. If any concerning signs or symptoms are present, the clinician documents findings and proceeds with appropriate imaging or referral. Typical site of service is outpatient clinic (dermatology, surgical oncology, or general oncology). The service type is a focused surveillance clinical assessment for absence of signs or symptoms of systemic melanoma spread, appropriate for routine follow-up visits or peri-procedural clearance assessments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for the visit due to complexity of assessment or documentation for melanoma surveillance |