HCPCS
Healthcare Common Procedure Coding System
HCPCS (Healthcare Common Procedure Coding System) codes are a set of medical billing codes used in the United States to identify healthcare services, procedures, and equipment not covered by the traditional CPT (Current Procedural Terminology) coding system. Administered by the Centers for Medicare & Medicaid Services (CMS), HCPCS codes are primarily used in the billing process for Medicare and Medicaid patients but are also utilized by other insurance companies. They are divided into two levels: Level I, which is identical to CPT codes and covers medical procedures and services, and Level II, which is unique to HCPCS and includes non-physician services such as ambulance rides, durable medical equipment, prosthetics, orthotics, and supplies. The purpose of HCPCS codes is to standardize the coding system for processing healthcare claims, thereby simplifying the billing and reimbursement process. They enable healthcare providers to accurately describe the services and supplies provided to patients and ensure that they are reimbursed correctly for these services. HCPCS codes are essential in healthcare administration for tracking utilization, conducting research, evaluating healthcare outcomes, and managing healthcare costs. Each HCPCS code is a unique alphanumeric code, providing a detailed and systematic way to classify and bill for a wide range of healthcare services and products, thus playing a critical role in the operational and financial aspects of the healthcare system.
HCPCS codes starting with G
- G0008Administration of influenza virus vaccineHCPCS
- G0009Administration of pneumococcal vaccineHCPCS
- G0010Administration of hepatitis b vaccineHCPCS
- G0027Semen analysis; presence and/or motility of sperm excluding huhnerHCPCS
- G0071Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes...HCPCS
- G0088Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biol...HCPCS
- G0101Cervical or vaginal cancer screening; pelvic and clinical breast examinationHCPCS
- G0102Prostate cancer screening; digital rectal examinationHCPCS
- G0103Prostate cancer screening; prostate specific antigen test (psa)HCPCS
- G0104Colorectal cancer screening; flexible sigmoidoscopyHCPCS
- G0105Colorectal cancer screening; colonoscopy on individual at high riskHCPCS
- G0106Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enemaHCPCS
- G0108Diabetes outpatient self-management training services, individual, per 30 minutesHCPCS
- G0109Diabetes outpatient self-management training services, group session (2 or more), per 30 minutesHCPCS
- G0115NETT; PSYCHOLOGICAL TESTINGHCPCS
- G0117Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologistHCPCS
- G0120Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.HCPCS
- G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high riskHCPCS
- G0123Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervisionHCPCS
- G0124Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physicianHCPCS
- G0127Trimming of dystrophic nails, any numberHCPCS
- G0129Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)HCPCS
- G0141Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physicianHCPCS
- G0143Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervisionHCPCS
- G0144Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervisionHCPCS
- G0145Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervisionHCPCS
- G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesHCPCS
- G0152Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutesHCPCS
- G0153Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutesHCPCS
- G0154Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutesHCPCS
- G0155Services of clinical social worker in home health or hospice settings, each 15 minutesHCPCS
- G0156Services of home health/hospice aide in home health or hospice settings, each 15 minutesHCPCS
- G0157Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutesHCPCS
- G0158Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutesHCPCS
- G0159Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutesHCPCS
- G0160Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutesHCPCS
- G0161Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutesHCPCS
- G0162Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home...HCPCS
- G0163Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for po...HCPCS
- G0164Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutesHCPCS
- G0166External counterpulsation, per treatment sessionHCPCS
- G0168Wound closure utilizing tissue adhesive(s) onlyHCPCS
- G0175Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient presentHCPCS
- G0176Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)HCPCS
- G0177Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)HCPCS
- G0179Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial...HCPCS
- G0180Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im...HCPCS
- G0181Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision...HCPCS
- G0182Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of pa...HCPCS
- G0199Re-evaluation of patient using speech generating devicesHCPCS
- G0202Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performedHCPCS
- G0204Diagnostic mammography, including computer-aided detection (cad) when performed; bilateralHCPCS
- G0206Diagnostic mammography, including computer-aided detection (cad) when performed; unilateralHCPCS
- G0237Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)HCPCS
- G0238Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)HCPCS
- G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)HCPCS
- G0245Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that...HCPCS
- G0246Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes:...HCPCS
- G0247Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the followi...HCPCS
- G0248Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: fac...HCPCS
- G0249Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in...HCPCS
- G0250Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more freq...HCPCS
- G0252Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)HCPCS
- G0257Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facilityHCPCS
- G0259Injection procedure for sacroiliac joint; arthrographyHCPCS
- G0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrographyHCPCS
- G0268Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testingHCPCS
- G0269Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)HCPCS
- G0270Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to fac...HCPCS
- G0271Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more indiv...HCPCS
- G0276Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trialHCPCS
- G0277Hyperbaric oxygen under pressure, full body chamber, per 30 minute intervalHCPCS
- G0278Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal a...HCPCS
- G0279Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)HCPCS
- G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care,...HCPCS
- G0282Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281HCPCS
- G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careHCPCS
- G0288Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgeryHCPCS
- G0289Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same kneeHCPCS
- G0293Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per dayHCPCS
- G0294Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per dayHCPCS
- G0296Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)HCPCS
- G0297Low dose ct scan (ldct) for lung cancer screeningHCPCS
- G0299Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutesHCPCS
- G0300Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutesHCPCS
- G0302Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of servicesHCPCS
- G0303Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of servicesHCPCS
- G0306Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential countHCPCS
- G0307Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)HCPCS
- G0328Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneousHCPCS
- G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a th...HCPCS
- G0333Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiaryHCPCS
- G0337Hospice evaluation and counseling services, pre-electionHCPCS
- G0339Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatmentHCPCS
- G0340Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of tre...HCPCS
- G0364Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of serviceHCPCS
- G0365Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)HCPCS
- G0372Physician service required to establish and document the need for a power mobility deviceHCPCS
- G0378Hospital observation service, per hourHCPCS
- G0379Direct admission of patient for hospital observation careHCPCS
- G0380Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room...HCPCS
- G0381Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room...HCPCS
- G0382Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room...HCPCS
- G0383Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room...HCPCS
- G0384Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room...HCPCS
- G0389Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screeningHCPCS
- G0390Trauma response team associated with hospital critical care serviceHCPCS
- G0396Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutesHCPCS
- G0397Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutesHCPCS
- G0398Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturationHCPCS
- G0399Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturationHCPCS
- G0400Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channelsHCPCS
- G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollmentHCPCS
- G0403Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and reportHCPCS
- G0404Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examinationHCPCS
- G0405Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examinationHCPCS
- G0406Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealthHCPCS
- G0407Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealthHCPCS
- G0408Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealthHCPCS
- G0410Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutesHCPCS
- G0411Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutesHCPCS
- G0412Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performedHCPCS
- G0415Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)HCPCS
- G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any methodHCPCS
- G0420Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hourHCPCS
- G0421Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hourHCPCS
- G0422Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per sessionHCPCS
- G0423Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per sessionHCPCS
- G0424Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per dayHCPCS
- G0425Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealthHCPCS
- G0426Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealthHCPCS
- G0427Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealthHCPCS
- G0429Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)HCPCS
- G0430Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedureHCPCS
- G0431Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounterHCPCS
- G0432Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screeningHCPCS
- G0433Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screeningHCPCS
- G0434Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounterHCPCS
- G0435Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screeningHCPCS
- G0436Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutesHCPCS
- G0437Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutesHCPCS
- G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visitHCPCS
- G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visitHCPCS
- G0442Annual alcohol misuse screening, 15 minutesHCPCS
- G0443Brief face-to-face behavioral counseling for alcohol misuse, 15 minutesHCPCS
- G0444Annual depression screening, 15 minutesHCPCS
- G0445High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutesHCPCS
- G0446Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutesHCPCS
- G0447Face-to-face behavioral counseling for obesity, 15 minutesHCPCS
- G0451Development testing, with interpretation and report, per standardized instrument formHCPCS
- G0452Molecular pathology procedure; physician interpretation and reportHCPCS
- G0453Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)HCPCS
- G0454Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialistHCPCS
- G0455Preparation with instillation of fecal microbiota by any method, including assessment of donor specimenHCPCS
- G0463Hospital outpatient clinic visit for assessment and management of a patientHCPCS
- G0466Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle...HCPCS
- G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes...HCPCS
- G0468Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished...HCPCS
- G0469Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered...HCPCS
- G0470Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc servi...HCPCS
- G0471Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)HCPCS
- G0472Hepatitis c antibody screening, for individual at high risk and other covered indication(s)HCPCS
- G0473Face-to-face behavioral counseling for obesity, group (2-10), 30 minutesHCPCS
- G0475Hiv antigen/antibody, combination assay, screeningHCPCS
- G0476Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap testHCPCS
- G0477Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when perform...HCPCS
- G0478Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed...HCPCS
- G0479Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation wh...HCPCS
- G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and l...HCPCS
- G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and l...HCPCS
- G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and l...HCPCS
- G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and l...HCPCS
- G0491Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrdHCPCS
- G0493Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possibl...HCPCS
- G0494Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need fo...HCPCS
- G0495Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutesHCPCS
- G0496Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutesHCPCS
- G0498Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assist...HCPCS
- G0499Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when pe...HCPCS
- G0500Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the mo...HCPCS
- G0505Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domici...HCPCS
- G0506Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)HCPCS
- G0508Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealthHCPCS
- G0509Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealthHCPCS
- G0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc pr...HCPCS
- G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for p...HCPCS
- G0514Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to...HCPCS
- G0515Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutesHCPCS
- G0516Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)HCPCS
- G0659Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms...HCPCS
- G1004Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria programHCPCS
- G1006Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria programHCPCS
- G1007Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria programHCPCS
- G1010Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria programHCPCS
- G1011Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria programHCPCS
- G1012Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria programHCPCS
- G1014Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria programHCPCS
- G1015Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria programHCPCS
- G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided with...HCPCS
- G2011Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutesHCPCS
- G2012Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m se...HCPCS
- G2023Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen sourceHCPCS
- G2024Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen sourceHCPCS
- G2025Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) onlyHCPCS
- G2058Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g205...HCPCS
- G2061Qualified nonphysician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutesHCPCS
- G2062Qualified nonphysician healthcare professional online assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutesHCPCS
- G2063Qualified nonphysician qualified healthcare professional assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutesHCPCS
- G2066Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and...HCPCS
- G2067Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid tr...HCPCS
- G2073Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tr...HCPCS
- G2074Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)HCPCS
- G2076Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision...HCPCS
- G2077Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code...HCPCS
- G2078Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedureHCPCS
- G2080Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedureHCPCS
- G2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administrationHCPCS
- G2089Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%HCPCS
- G2099Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encoun...HCPCS
- G2102Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewedHCPCS
- G2115Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement periodHCPCS
- G2116Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encoun...HCPCS
- G2122Psychosis, depression, anxiety, apathy, and impulse control disorder not assessedHCPCS
- G2168Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutesHCPCS
- G2170Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, an...HCPCS
- G2193Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)HCPCS
- G2204Patients between 50 and 85 years of age who received a screening colonoscopy during the performance periodHCPCS
- G2211Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patie...HCPCS
- G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician...HCPCS
- G2214Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health c...HCPCS
- G6001Ultrasonic guidance for placement of radiation therapy fieldsHCPCS
- G6002Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapyHCPCS
- G6006Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greaterHCPCS
- G6012Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mevHCPCS
- G6013Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mevHCPCS
- G6014Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greaterHCPCS
- G6015Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment sessionHCPCS
- G6017Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatmentHCPCS
- G6031BenzodiazepinesHCPCS
- G6032DesipramineHCPCS
- G6034DoxepinHCPCS
- G6038SalicylateHCPCS
- G6039AcetaminophenHCPCS
- G6040Alcohol (ethanol); any specimen except breathHCPCS
- G6042Amphetamine or methamphetamineHCPCS
- G6043Barbiturates, not elsewhere specifiedHCPCS
- G6044Cocaine or metaboliteHCPCS
- G6052MeprobamateHCPCS
- G6053MethadoneHCPCS
- G6055NicotineHCPCS
- G6056Opiate(s), drug and metabolites, each procedureHCPCS
- G6058Drug confirmation, each procedureHCPCS
- G8081End stage renal disease patient requiring hemodialysis vascular access documented to have received autogenous av fistulaHCPCS
- G8082End stage renal disease patient requiring hemodialysis documented to have received vascular access other than autogenous av fistulaHCPCS
- G8370Asthma patients with numeric frequency of symptoms or patient completion of an asthma assessment tool/survey/questionnaire not documentedHCPCS
- G8397Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathyHCPCS
- G8398Dilated macular or fundus exam not performedHCPCS
- G8399Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performedHCPCS
- G8400Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not givenHCPCS
- G8401Clinician documented that patient was not an eligible candidate for screeningHCPCS
- G8404Lower extremity neurological exam performed and documentedHCPCS
- G8409Clinician documented that patient was not an eligible candidate for abi measurement measureHCPCS
- G8410Footwear evaluation performed and documentedHCPCS
- G8415Footwear evaluation was not performedHCPCS
- G8417Bmi is documented above normal parameters and a follow-up plan is documentedHCPCS
- G8418Bmi is documented below normal parameters and a follow-up plan is documentedHCPCS
- G8419Bmi documented outside normal parameters, no follow-up plan documented, no reason givenHCPCS
- G8420Bmi is documented within normal parameters and no follow-up plan is requiredHCPCS
- G8421Bmi not documented and no reason is givenHCPCS
- G8422Bmi not documented, documentation the patient is not eligible for bmi calculationHCPCS
- G8427Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medicationsHCPCS
- G8428Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not givenHCPCS
- G8430Eligible clinician attests to documenting in the medical record the patient is not eligible for a current list of medications being obtained, updated, or reviewed by the eligible clinicianHCPCS
- G8431Screening for depression is documented as being positive and a follow-up plan is documentedHCPCS
- G8432Depression screening not documented, reason not givenHCPCS
- G8433Screening for depression not completed, documented reasonHCPCS
- G8442Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounterHCPCS
- G8450Beta-blocker therapy prescribedHCPCS
- G8451Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical re...HCPCS
- G8452Beta-blocker therapy not prescribedHCPCS
- G8473Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribedHCPCS
- G8474Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mit...HCPCS
- G8476Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhgHCPCS
- G8477Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhgHCPCS
- G8478Blood pressure measurement not performed or documented, reason not givenHCPCS
- G8482Influenza immunization administered or previously receivedHCPCS
- G8483Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)HCPCS
- G8484Influenza immunization was not administered, reason not givenHCPCS
- G8485I intend to report the diabetes mellitus (dm) measures groupHCPCS
- G8489I intend to report the coronary artery disease (cad) measures groupHCPCS
- G8494All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patientHCPCS
- G8496All quality actions for the applicable measures in the preventive care measures group have been performed for this patientHCPCS
- G8506Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapyHCPCS
- G8509Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not givenHCPCS
- G8510Screening for depression is documented as negative, a follow-up plan is not requiredHCPCS
- G8511Screening for depression documented as positive, follow-up plan not documented, reason not givenHCPCS
- G8535Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounterHCPCS
- G8536No documentation of an elder maltreatment screen, reason not givenHCPCS
- G8539Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documentedHCPCS
- G8540Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounterHCPCS
- G8541Functional outcome assessment using a standardized tool not documented, reason not givenHCPCS
- G8542Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not requiredHCPCS
- G8543Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not givenHCPCS
- G8553Prescription(s) generated and transmitted via a qualified erx systemHCPCS
- G8598Aspirin or another antiplatelet therapy usedHCPCS
- G8599Aspirin or another antiplatelet therapy not used, reason not givenHCPCS
- G8600Iv t-pa initiated within three hours (<= 180 minutes) of time last known wellHCPCS
- G8601Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinicianHCPCS
- G8602Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not givenHCPCS
- G8696Antithrombotic therapy prescribed at dischargeHCPCS
- G8697Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))HCPCS
- G8709Patient prescribed or dispensed antibiotic for documented medical reason(s) within three days after the initial diagnosis of uri (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis...HCPCS
- G8711Prescribed or dispensed antibioticHCPCS
- G8712Antibiotic not prescribed or dispensedHCPCS
- G8721Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology reportHCPCS
- G8725Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)HCPCS
- G8726Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)HCPCS
- G8730Pain assessment documented as positive using a standardized tool and a follow-up plan is documentedHCPCS
- G8731Pain assessment using a standardized tool is documented as negative, no follow-up plan requiredHCPCS
- G8732No documentation of pain assessment, reason not givenHCPCS
- G8733Elder maltreatment screen documented as positive and a follow-up plan is documentedHCPCS
- G8734Elder maltreatment screen documented as negative, no follow-up requiredHCPCS
- G8735Elder maltreatment screen documented as positive, follow-up plan not documented, reason not givenHCPCS
- G8749Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the po...HCPCS
- G8752Most recent systolic blood pressure < 140 mmhgHCPCS
- G8753Most recent systolic blood pressure >= 140 mmhgHCPCS
- G8754Most recent diastolic blood pressure < 90 mmhgHCPCS
- G8755Most recent diastolic blood pressure >= 90 mmhgHCPCS
- G8756No documentation of blood pressure measurement, reason not givenHCPCS
- G8783Normal blood pressure reading documented, follow-up not requiredHCPCS
- G8784Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)HCPCS
- G8785Blood pressure reading not documented, reason not givenHCPCS
- G8797Specimen site other than anatomic location of esophagusHCPCS
- G8798Specimen site other than anatomic location of prostateHCPCS
- G8806Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documentedHCPCS
- G8808Trans-abdominal or trans-vaginal ultrasound not performed, reason not givenHCPCS
- G8810Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)HCPCS
- G8839Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepinessHCPCS
- G8842Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosisHCPCS
- G8845Positive airway pressure therapy prescribedHCPCS
- G8851Objective measurement of adherence to positive airway pressure therapy, documentedHCPCS
- G8852Positive airway pressure therapy prescribedHCPCS
- G8856Referral to a physician for an otologic evaluation performedHCPCS
- G8857Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)HCPCS
- G8864Pneumococcal vaccine administered or previously receivedHCPCS
- G8867Pneumococcal vaccine not administered or previously received, reason not givenHCPCS
- G8875Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy methodHCPCS
- G8876Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition...HCPCS
- G8883Biopsy results reviewed, communicated, tracked and documentedHCPCS
- G8902I intend to report the dementia measures groupHCPCS
- G8903I intend to report the parkinson's disease measures groupHCPCS
- G8907Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facilityHCPCS
- G8908Patient documented to have received a burn prior to dischargeHCPCS
- G8910Patient documented to have experienced a fall within ascHCPCS
- G8914Patient documented to have experienced a hospital transfer or hospital admission upon discharge from ascHCPCS
- G8915Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from ascHCPCS
- G8916Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on timeHCPCS
- G8917Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on timeHCPCS
- G8918Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxisHCPCS
- G8923Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic functionHCPCS
- G8924Spirometry test results demonstrate fev1/fvc < 70%, fev < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)HCPCS
- G8925Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptomsHCPCS
- G8927Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancerHCPCS
- G8934Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic functionHCPCS
- G8935Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapyHCPCS
- G8938Bmi is documented as being outside of normal limits, follow-up plan is not documented, documentation the patient is not eligibleHCPCS
- G8939Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounterHCPCS
- G8940Screening for depression documented as positive, a follow-up plan not completed, documented reasonHCPCS
- G8941Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounterHCPCS
- G8942Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documentedHCPCS
- G8947One or more neuropsychiatric symptomsHCPCS
- G8950Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documentedHCPCS
- G8952Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not givenHCPCS
- G8959Clinician treating major depressive disorder communicates to clinician treating comorbid conditionHCPCS
- G8960Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not givenHCPCS
- G8966Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessmentHCPCS
- G8967Warfarin or another fda approved oral anticoagulant is prescribedHCPCS
- G8968Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)HCPCS
- G8969Documentation of patient reason(s) for not prescribing warfarin or another fda-approved oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)HCPCS
- G8971Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not givenHCPCS
- G8972One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolismHCPCS
- G8978Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8979Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8980Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8981Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8982Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8983Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8984Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8985Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8986Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8987Self care functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8988Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8989Self care functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8990Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8991Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8992Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8993Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervalsHCPCS
- G8994Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8995Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8996Swallowing functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G8997Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G8998Swallowing functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G8999Motor speech functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9001Coordinated care fee, initial rateHCPCS
- G9002Coordinated care fee, maintenance rateHCPCS
- G9012Other specified case management service not elsewhere classifiedHCPCS
- G9016Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]HCPCS
- G9017Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)HCPCS
- G9019Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)HCPCS
- G9035Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)HCPCS
- G9097Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease pro...HCPCS
- G9150National committee for quality assurance - level 3 medical homeHCPCS
- G9151Mapcp demonstration - state provided servicesHCPCS
- G9157Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposesHCPCS
- G9158Motor speech functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G9159Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9160Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9161Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reportingHCPCS
- G9162Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9163Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9164Spoken language expression functional limitation, discharge status at discharge from therapy or to end reportingHCPCS
- G9165Attention functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9166Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9167Attention functional limitation, discharge status at discharge from therapy or to end reportingHCPCS
- G9168Memory functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9169Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9170Memory functional limitation, discharge status at discharge from therapy or to end reportingHCPCS
- G9171Voice functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9172Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9173Voice functional limitation, discharge status at discharge from therapy or to end reportingHCPCS
- G9174Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervalsHCPCS
- G9175Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9176Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reportingHCPCS
- G9186Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingHCPCS
- G9189Beta-blocker therapy prescribed or currently being takenHCPCS
- G9196Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patien...HCPCS
- G9197Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxisHCPCS
- G9198Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not givenHCPCS
- G9223Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%HCPCS
- G9225Foot exam was not performed, reason not givenHCPCS
- G9226Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception thres...HCPCS
- G9227Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounterHCPCS
- G9228Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)HCPCS
- G9231Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement periodHCPCS
- G9250Documentation of patient pain brought to a comfortable level within 48 hours from initial assessmentHCPCS
- G9251Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessmentHCPCS
- G9266Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular accessHCPCS
- G9270Documentation of patient without one or more complications within 90 daysHCPCS
- G9273Blood pressure has a systolic value of < 140 and a diastolic value of < 90HCPCS
- G9275Documentation that patient is a current non-tobacco userHCPCS
- G9296Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedureHCPCS
- G9298Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)HCPCS
- G9301Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquetHCPCS
- G9304Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implantHCPCS
- G9305Intervention for presence of leak of endoluminal contents through an anastomosis not requiredHCPCS
- G9306Intervention for presence of leak of endoluminal contents through an anastomosis requiredHCPCS
- G9307No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedureHCPCS
- G9309No unplanned hospital readmission within 30 days of principal procedureHCPCS
- G9310Unplanned hospital readmission within 30 days of principal procedureHCPCS
- G9311No surgical site infectionHCPCS
- G9313Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reasonHCPCS
- G9315Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosisHCPCS
- G9316Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or familyHCPCS
- G9318Imaging study named according to standardized nomenclatureHCPCS
- G9319Imaging study not named according to standardized nomenclature, reason not givenHCPCS
- G9321Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current studyHCPCS
- G9322Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not givenHCPCS
- G9326Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not givenHCPCS
- G9327Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elementsHCPCS
- G9329Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final repo...HCPCS
- G9340Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the studyHCPCS
- G9342Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, sha...HCPCS
- G9345Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factorsHCPCS
- G9347Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not givenHCPCS
- G9350Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosisHCPCS
- G9357Post-partum screenings, evaluations and education performedHCPCS
- G9359Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to the treatment with a biologic immune response modifierHCPCS
- G9365One high-risk medication orderedHCPCS
- G9366One high-risk medication not orderedHCPCS
- G9368At least two orders for the same high-risk medications not orderedHCPCS
- G9396Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)HCPCS
- G9416Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdaysHCPCS
- G9418Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanationHCPCS
- G9420Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancerHCPCS
- G9422Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)HCPCS
- G9427Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patientsHCPCS
- G9428Pathology report includes the pt category and a statement on thickness, ulceration and mitotic rateHCPCS
- G9429Documentation of medical reason(s) for not including pt category and a statement on thickness, ulceration and mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)HCPCS
- G9430Specimen site other than anatomic cutaneous locationHCPCS
- G9432Asthma well-controlled based on the act, c-act, acq, or ataq score and results documentedHCPCS
- G9434Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not givenHCPCS
- G9458Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or r...HCPCS
- G9486Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a...HCPCS
- G9487Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused h...HCPCS
- G9488Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detaile...HCPCS
- G9489Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a c...HCPCS
- G9500Radiation exposure indices, or exposure time and number of fluorographic images in final report for procedures using fluoroscopy, documentedHCPCS
- G9501Radiation exposure indices, or exposure time and number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not givenHCPCS
- G9512Individual had a pdc of 0.8 or greaterHCPCS
- G9526Patient was not referred to hospice care, reason not givenHCPCS
- G9529Patient with minor blunt head trauma had an appropriate indication(s) for a head ctHCPCS
- G9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care providerHCPCS
- G9531Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine,...HCPCS
- G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than traumaHCPCS
- G9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ctHCPCS
- G9534Advanced brain imaging (cta, ct, mra or mri) was not orderedHCPCS
- G9535Patients with a normal neurological examinationHCPCS
- G9537Documentation of system reason(s) for obtaining imaging of the head (ct or mri) (i.e., needed as part of a clinical trial; other clinician ordered the study)HCPCS
- G9538Advanced brain imaging (cta, ct, mra or mri) was orderedHCPCS
- G9547Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct,...HCPCS
- G9548Final reports for imaging studies stating no follow-up imaging is recommendedHCPCS
- G9549Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))HCPCS
- G9550Final reports for imaging studies with follow-up imaging recommendedHCPCS
- G9551Final reports for imaging studies without an incidentally found lesion notedHCPCS
- G9552Incidental thyroid nodule < 1.0 cm noted in reportHCPCS
- G9554Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging recommendedHCPCS
- G9555Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))HCPCS
- G9556Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging not recommendedHCPCS
- G9557Final reports for ct, cta, mri or mra studies of the chest or neck or ultrasound of the neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule foundHCPCS
- G9558Patient treated with a beta-lactam antibiotic as definitive therapyHCPCS
- G9560Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not givenHCPCS
- G9561Patients prescribed opiates for longer than six weeksHCPCS
- G9562Patients who had a follow-up evaluation conducted at least every three months during opioid therapyHCPCS
- G9577Patients prescribed opiates for longer than six weeksHCPCS
- G9578Documentation of signed opioid treatment agreement at least once during opioid therapyHCPCS
- G9583Patients prescribed opiates for longer than six weeksHCPCS
- G9584Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapyHCPCS
- G9593Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rulesHCPCS
- G9594Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care providerHCPCS
- G9597Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rulesHCPCS
- G9600Symptomatic aaas that required urgent/emergent (non-elective) repairHCPCS
- G9612Photodocumentation of two or more cecal landmarks to establish a complete examinationHCPCS
- G9613Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)HCPCS
- G9615Preoperative assessment documentedHCPCS
- G9618Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kindHCPCS
- G9622Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening methodHCPCS
- G9634Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improvedHCPCS
- G9637Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)HCPCS
- G9638Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)HCPCS
- G9649Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))HCPCS
- G9654Monitored anesthesia care (mac)HCPCS
- G9655A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is usedHCPCS
- G9656Patient transferred directly from anesthetizing location to pacu or other non-icu locationHCPCS
- G9657Transfer of care during an anesthetic or to the intensive care unitHCPCS
- G9664Patients who are currently statin therapy users or received an order (prescription) for statin therapyHCPCS
- G9678Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participa...HCPCS
- G9687Hospice services provided to patient any time during the measurement periodHCPCS
- G9690Patient receiving hospice services any time during the measurement periodHCPCS
- G9691Patient had hospice services any time during the measurement periodHCPCS
- G9692Hospice services received by patient any time during the measurement periodHCPCS
- G9693Patient use of hospice services any time during the measurement periodHCPCS
- G9694Hospice services utilized by patient any time during the measurement periodHCPCS
- G9695Long-acting inhaled bronchodilator prescribedHCPCS
- G9696Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilatorHCPCS
- G9697Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilatorHCPCS
- G9699Long-acting inhaled bronchodilator not prescribed, reason not otherwise specifiedHCPCS
- G9707Patient received hospice services any time during the measurement periodHCPCS
- G9710Patient was provided hospice services any time during the measurement periodHCPCS
- G9712Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection o...HCPCS
- G9716Bmi is documented as being outside of normal limits, follow-up plan is not completed for documented reasonHCPCS
- G9717Documentation stating the patient has an active diagnosis of depression or has a diagnosed bipolar disorder, therefore screening or follow-up not requiredHCPCS
- G9718Hospice services for patient provided any time during the measurement periodHCPCS
- G9720Hospice services for patient occurred any time during the measurement periodHCPCS
- G9724Patients who had documentation of use of anticoagulant medications overlapping the measurement yearHCPCS
- G9730Patient refused to participateHCPCS
- G9741Patients who use hospice services any time during the measurement periodHCPCS
- G9744Patient not eligible due to active diagnosis of hypertensionHCPCS
- G9745Documented reason for not screening or recommending a follow-up for high blood pressureHCPCS
- G9754A finding of an incidental pulmonary noduleHCPCS
- G9771At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end timeHCPCS
- G9774Patients who have had a hysterectomyHCPCS
- G9785Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissu...HCPCS
- G9842Patient has metastatic disease at diagnosisHCPCS
- G9856Patient was not admitted to hospiceHCPCS
- G9873First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp...HCPCS
- G9874Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of th...HCPCS
- G9875Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of th...HCPCS
- G9876Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp...HCPCS
- G9877Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdp...HCPCS
- G9878Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp...HCPCS
- G9879Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdp...HCPCS
- G9880The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% w...HCPCS
- G9881The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as...HCPCS
- G9882Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by...HCPCS
- G9883Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by...HCPCS
- G9884Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by...HCPCS
- G9891Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the...HCPCS
- G9899Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewedHCPCS
- G9900Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specifiedHCPCS
- G9902Patient screened for tobacco use and identified as a tobacco userHCPCS
- G9903Patient screened for tobacco use and identified as a tobacco non-userHCPCS
- G9904Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)HCPCS
- G9905Patient not screened for tobacco use, reason not givenHCPCS
- G9906Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)HCPCS
- G9907Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)HCPCS
- G9908Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy), reason not givenHCPCS
- G9910Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement periodHCPCS
- G9916Functional status performed once in the last 12 monthsHCPCS
- G9918Functional status not performed, reason not otherwise specifiedHCPCS
- G9919Screening performed and positive and provision of recommendationsHCPCS
- G9920Screening performed and negativeHCPCS
- G9921No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specifiedHCPCS
- G9922Safety concerns screen provided and if positive then documented mitigation recommendationsHCPCS
- G9923Safety concerns screen provided and negativeHCPCS
- G9925Safety concerns screening not provided, reason not otherwise specifiedHCPCS
- G9928Warfarin or another fda-approved anticoagulant not prescribed, reason not givenHCPCS
- G9929Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)HCPCS
- G9931Documentation of cha2ds2-vasc risk score of 0 or 1HCPCS
- G9969Provider who referred the patient to another provider received a report from the provider to whom the patient was referredHCPCS
- G9974Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severityHCPCS