G8927 HCPCS Reimbursement & Policy

HCPCS Level II code G8927 documents that adjuvant chemotherapy has been referred, prescribed, or previously received for AJCC stage III colon cancer. This code captures a specific clinical and administrative status used in oncology care coordination, quality measurement, and treatment planning. Nationally, consistent use of G8927 supports accurate tracking of adjuvant therapy for a population at elevated risk of recurrence and informs care transitions between surgical, medical oncology, and supportive services.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context, expected sites of service (oncology clinics and outpatient infusion centers), and the care coordination purpose it serves. The publication outlines where this code fits in documentation workflows and what stakeholders commonly monitor (receipt or referral for adjuvant chemotherapy in stage III colon cancer).

The article provides operational benchmarks and policy-relevant points for national audiences: how G8927 is used in claims to reflect chemotherapy status, implications for quality measurement and care continuity, and considerations for aligning clinical documentation with payer requirements. Data not available in the input are noted where applicable.

Billing Code Overview

HCPCS Level II code G8927 indicates adjuvant chemotherapy referred, prescribed or previously received for AJCC stage III colon cancer. The service type is oncology-related care coordination and documentation of chemotherapy status tied to treatment planning and quality reporting. The typical site of service is oncology clinic or outpatient infusion center, where referrals, prescriptions, and treatment histories for stage III colon cancer are documented and managed.

Data not available in the input.

Clinical Context

A typical patient is a 58-year-old individual recently diagnosed with AJCC Stage III colon adenocarcinoma following colon resection. The multidisciplinary oncology team documents the recommendation for adjuvant chemotherapy to reduce recurrence risk. Outpatient oncology clinic staff enter an order for intravenous adjuvant chemotherapy, counsel the patient on regimen, toxicity, and schedule, and coordinate port/line access and infusion appointments. Prior to first infusion, baseline labs (CBC, CMP), performance status assessment, and consent are completed. The billing entry for the care coordination, referral, and documentation that adjuvant chemotherapy was prescribed or previously received is reported using G8927. Typical visits include initial medical oncology consultation, chemotherapy education session, central venous access placement (if needed), and serial infusion visits. Typical site of service is outpatient oncology infusion center or ambulatory clinic; some documentation events may occur in office-based medical oncology practices or hospital outpatient departments.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management (E/M) service by the same physician on the day of a procedure	Use when a distinct E/M visit is documented on the same day as an infusion or minor procedure related to chemotherapy referral.

Taxonomy Code	Specialty	Notes
`207RG0300X`	Medical Oncology	Primary specialty that prescribes and manages adjuvant chemotherapy for colon cancer.
`207RH0000X`	Hematology/Oncology	Specialists who jointly manage systemic therapy and supportive care.
`207Q00000X`	Oncology Nurse Practitioner	Advanced practice providers who perform chemotherapy education, consenting, and follow-up.
`363A00000X`	Hospitalist (Oncology practice in hospital outpatient)	Providers coordinating inpatient-to-outpatient transitions and chemotherapy initiation.
`365A00000X`	General Surgery	Surgeons who perform colon resections and document postoperative global periods relevant to adjuvant therapy timing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C18.2`	Malignant neoplasm of ascending colon	Stage III colon cancers in the ascending colon commonly require adjuvant chemotherapy after resection.
`C18.3`	Malignant neoplasm of hepatic flexure	Tumors at the hepatic flexure may be Stage III and require adjuvant systemic therapy following surgery.
`C18.4`	Malignant neoplasm of transverse colon	Transverse colon adenocarcinomas staged as AJCC Stage III are indications for adjuvant chemotherapy.
`C18.5`	Malignant neoplasm of splenic flexure	Splenic flexure cancers with node-positive disease are treated with adjuvant chemotherapy.
`C18.7`	Malignant neoplasm of sigmoid colon	Sigmoid colon Stage III tumors commonly receive adjuvant chemotherapy to reduce recurrence risk.
`C18.9`	Malignant neoplasm of colon, unspecified	Used when the specific colon subsite is not documented but adjuvant chemotherapy is indicated for Stage III disease.
`Z85.038`	Personal history of malignant neoplasm of large intestine	Relevant for surveillance and documenting prior malignancy when considering additional adjuvant therapy.
`Z85.048`	Personal history of malignant neoplasm of rectosigmoid junction	May be used when prior colorectal cancer history factors into current adjuvant treatment decisions.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	Commonly billed for individual adjuvant chemotherapy infusion visits that follow the referral/prescription documented by `G8927`.
`96415`	Chemotherapy administration, IV infusion; each additional hour (List separately in addition to code for primary infusion)	Used when infusion sessions for adjuvant regimens extend beyond the primary hour and require additional time-based billing.
`36561`	Insertion of tunneled central venous catheter, without subcutaneous port or pump	Performed when long-term central access is required for adjuvant chemotherapy delivery prior to first infusion.
`96417`	Chemotherapy administration, IV infusion; additional sequential intravenous drugs for the same session	Used for multi-drug adjuvant regimens administered sequentially during the same infusion encounter.
`99204`	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	May be used for the initial medical oncology consultation where adjuvant chemotherapy is prescribed and documented for billing with `G8927`.

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Summary & Overview

HCPCS G8927: Adjuvant Chemotherapy for AJCC Stage III Colon Cancer