Summary & Overview
HCPCS G9847: Systemic Cancer-Directed Therapy in Last 14 Days of Life
HCPCS Level II code G9847 documents when a patient received systemic cancer-directed therapy during the final 14 days of life. The measure is clinically important as it captures end-of-life treatment intensity and is used in quality measurement and program monitoring to assess appropriateness of aggressive care near death. Nationally, this code informs payer policies, hospice and palliative care metrics, and broader efforts to align care with patient goals at end of life. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code represents clinically, typical sites where the service is delivered, and how the code is used in quality reporting and administrative datasets. The publication provides benchmarks and usage context, explains common billing practices where available, and outlines policy considerations tied to end-of-life oncology care. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and detailed payer-specific reimbursement rules. The content is intended for administrators, coders, payers, and clinicians seeking a concise reference on the role of G9847 in measuring systemic cancer therapy delivered in the last 14 days of life.
Billing Code Overview
HCPCS Level II code G9847 indicates that a patient received systemic cancer-directed therapy in the last 14 days of life. This code documents end-of-life systemic oncology treatment delivered close to death.
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Service type: Systemic cancer-directed therapy
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Typical site of service: Hospital inpatient or outpatient oncology infusion centers where systemic anti-cancer treatments are administered
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult with advanced or metastatic cancer receiving systemic cancer-directed therapy (chemotherapy, targeted therapy, immunotherapy, or hormonal therapy) who dies within 14 days of receiving the treatment. The clinical workflow begins when an oncologist documents the intent and regimen for systemic therapy in the outpatient infusion center, hospital inpatient unit, or hospice setting. The patient may receive therapy in an ambulatory infusion suite, outpatient oncology clinic, or inpatient oncology ward. If the patient dies within 14 days of administration, billing staff apply the HCPCS Level II code G9847 to indicate receipt of systemic cancer-directed therapy in the last 14 days of life. Relevant documentation includes the medication administration record, infusion center or hospital nursing notes, oncologist progress notes documenting treatment intent, dates of administration, and the date of death. Use of G9847 supports quality measurement and palliative care metrics and is reported by facilities or practitioners according to payer rules.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or resources exceed typical requirements for administration/documentation of therapy (rare for standard infusions). |