Summary & Overview
HCPCS G9102: Gastric Adenocarcinoma Disease Status Assessment
HCPCS Level II code G9102 designates a disease status assessment for gastric cancer when adenocarcinoma is the predominant cell type and the condition is clinically or pathologically m0, unresectable without progression, or metastatic. The code is intended for use within a Medicare-approved demonstration project and captures a specific oncology staging and status scenario that can affect care coordination, reporting, and demonstration-specific reimbursement practices. Nationally, this code matters because it standardizes reporting for a narrowly defined gastric cancer population within demonstration initiatives, supporting consistent clinical documentation and potential program evaluation.
Key payers included in the national discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the code, expected settings of service, and which payers commonly engage with disease-status reporting in oncology demonstration projects. The publication also outlines benchmarking elements, policy context relevant to demonstration projects, and the clinical scenarios that make the code applicable. Data not available in the input are noted where relevant, and readers will learn which details require payer-specific guidance or demonstration-project documentation.
Billing Code Overview
HCPCS Level II code G9102 describes a disease status assessment for gastric cancer, limited to adenocarcinoma as the predominant cell type. The code applies when the clinical or pathologic stage is m0, the tumor is unresectable with no evidence of disease progression, or there are metastases, and is designated for use in a Medicare-approved demonstration project.
-
Service type: Oncology disease status assessment
-
Typical site of service: Oncology clinic, hospital outpatient department, or other settings where cancer disease status evaluations are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of gastric adenocarcinoma referred for longitudinal disease-status assessment as part of a Medicare-approved demonstration project. The patient previously underwent diagnostic staging (endoscopy with biopsy and imaging) and either systemic therapy or palliative interventions because the tumor is clinically or pathologically staged as M0 but deemed unresectable, or has prior treated metastases without active progression. The clinical workflow includes an oncology clinic visit where the treating medical oncologist or surgical oncologist documents disease status (clinical or pathologic M0, unresectable) and documents absence of disease progression or active metastases. Relevant data sources reviewed during the encounter include recent imaging (CT, PET/CT), pathology reports confirming adenocarcinoma predominance, operative notes if prior procedures occurred, and treatment records. The clinician documents the disease-status assessment and enters the appropriate billing code G9102 to report the disease-status classification for participation in the demonstration project. Typical sites of service are outpatient oncology clinics, hospital outpatient departments, and specialty cancer centers participating in the Medicare demonstration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |