Medical Billing Code Search
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8892 results found
| 0337U | Onc plsm cell do & myeloma ID | Description: Oncology (plasma cell disorders and myeloma), circulating plasma cell immunologic selection, identification, morphological characterization, and enumeration of plasma cells based on differential CD138, CD38, CD19, and CD45 protein biomarker expression, peripheral blood |
| 0338U | Onc sld tum crcg tum cl slct | Description: Oncology (solid tumor), circulating tumor cell selection, identification, morphological characterization, detection and enumeration based on differential EpCAM, cytokeratins 8, 18, and 19, and CD45 protein biomarkers, and quantification of HER2 protein biomarker–expressing cells, peripheral blood |
| 0339U | Onc prst8 mrna hoxc6 & dlx1 | Description: Oncology (prostate), mRNA expression profiling of HOXC6 and DLX1, reverse transcription polymerase chain reaction (RT-PCR), first-void urine following digital rectal examination, algorithm reported as probability of high-grade cancer |
| 0340U | Onc pan ca alys mrd plasma | Description: Oncology (pan-cancer), analysis of minimal residual disease (MRD) from plasma, with assays personalized to each patient based on prior next-generation sequencing of the patient’s tumor and germline DNA, reported as absence or presence of MRD, with disease-burden correlation, if appropriate |
| 0341U | Ftl aneup dna seq cmpr alys | Description: Fetal aneuploidy DNA sequencing comparative analysis, fetal DNA from products of conception, reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism, and segmental aneuploid |
| 0342U | Onc pncrtc ca mult ia eclia | Description: Oncology (pancreatic cancer), multiplex immunoassay of C5, C4, cystatin C, factor B, osteoprotegerin (OPG), gelsolin, IGFBP3, CA125 and multiplex electrochemiluminescent immunoassay (ECLIA) for CA19-9, serum, diagnostic algorithm reported qualitatively as positive, negative, or borderline |
| 0343U | Onc prst8 xom aly 442 sncrna | Description: Oncology (prostate), exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR), urine, reported as molecular evidence of no-, low-, intermediate- or high-risk of prostate cancer |
| 0344U | Hep nafld semiq evl 28 lipid | Description: Hepatology (nonalcoholic fatty liver disease [NAFLD]), semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS), serum, reported as at-risk for nonalcoholic steatohepatitis (NASH) or not NASH |
| 0345U | Psyc genom alys pnl 15 gen | Description: Psychiatry (eg, depression, anxiety, attention deficit hyperactivity disorder [ADHD]), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6 |
| 0346U | Beta amyl Aβ40 & Aβ42 lcms/ms | Description: Beta amyloid, Aβ40 and Aβ42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS), ratio, plasma |
| 0347U | Rx metab/pcx dna 16 gen alys | Description: Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes |
| 0348U | Rx metab/pcx dna 25 gen alys | Description: Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes |
| 0349U | Rx metab/pcx dna 27gen rx ia | Description: Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interactions |
| 0350U | Rx metab/pcx dna 27 gen alys | Description: Drug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis and reported phenotypes |
| 0351U | Nfct ds bct/viral trail ip10 | Description: Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP10), and C-reactive protein, serum, algorithm reported as likelihood of bacterial infection |
| 0352U | Nfct ds bv&vaginitis amp prb | Description: Infectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis–associated bacteria (BVAB-2, Atopobium vaginae, and Megasphera type 1), algorithm reported as detected or not detected and separate detection of Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata/Candida krusei, and trichomonas vaginalis, vaginal-fluid specimen, each result reported as detected or not detected |
| 0353U | Iadna chlmyd&gonorr amp prb | Description: Infectious agent detection by nucleic acid (DNA), Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique, urine, vaginal, pharyngeal, or rectal, each pathogen reported as detected or not detected |
| 0354U | Hpv hi rsk qual mrna E6/E7 | Description: Human papilloma virus (HPV), high-risk types (ie, 16, 18, 31, 33, 45, 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR) |
| 0355U | APOL1 RISK VARIANTS | Description: APOL1 (apolipoprotein L1) (eg, chronic kidney disease), risk variants (G1, G2) |
| 0356U | ONC OROP 17 DNA DDPCR ALG | Description: Oncology (oropharyngeal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence |
| 0357U | ONC MLNMA AI QUAN ALYS 142 | Description: Oncology (melanoma), artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments, plasma, prognostic, and predictive algorithm reported as likely, unlikely, or uncertain benefit from immunotherapy agents |
| 0358U | NEURO ALYS β-AMYL 1-42&1-40 | Description: Neurology (mild cognitive impairment), analysis of β-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative |
| 0359U | ONC PRST8 CA ALYS ALL PSA | Description: Oncology (prostate cancer), analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer |
| 0360U | ONC LUNG ELISA 7 AUTOANT ALG | Description: Oncology (lung), enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53, NY-ESO-1, CAGE, GBU4-5, SOX2, MAGE A4, and HuD), plasma, algorithm reported as a categorical result for risk of malignancy |
| 0361U | NEURFLMNT LT CHN DIG IA QUAN | Description: U Neurofilament light chain, digital immunoassay, plasma, quantitative |
| 0362U | ONC PAP THYR CA RNA 82&10 | Description: Oncology (papillary thyroid cancer), gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes, formalin-fixed paraffin embedded (FFPE) tissue, algorithm reported as one of three molecular subtypes |
| 0363U | ONC URTHL MRNA 5 GEN ALG | Description: Oncology (urothelial), mRNA, geneexpression profiling by real-time quantitative PCR of 5 genes (MDK, HOXA13, CDC2 [CDK1], IGFBP5, and CXCR2), utilizing urine, algorithm incorporates age, sex, smoking history, and macrohematuria frequency, reported as a risk score for having urothelial carcinoma |
| 0364U | ONC HL NEO GEN SEQ ALYS ALG | Description: Oncology (hematolymphoid neoplasm), genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm, quantification of dominant clonal sequence(s), reported as presence or absence of minimal residual disease (MRD) with quantitation of disease burden, when appropriate |
| 0365U | ONC BLDR 10 PRB BLDR CA | Description: Oncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, algorithm reported as a probability of bladder cancer |
| 0366U | ONC BLDR 10 PRB RECR BLDR CA | Description: Oncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer |
| 0367U | ONC BLDR 10 FLWG TRURL RESCJ | Description: Oncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, diagnostic algorithm reported as a risk score for probability of rapid recurrence of recurrent or persistent cancer following transurethral resection |
| 0368U | ONC CLRCT CA MUT&MTHYLTN MRK | Description: Oncology (colorectal cancer), evaluation for mutations of APC, BRAF, CTNNB1, KRAS, NRAS, PIK3CA, SMAD4, and TP53, and methylation markers (MYO1G, KCNQ5, C9ORF50, FLI1, CLIP4, ZNF132 and TWIST1), multiplex quantitative polymerase chain reaction (qPCR), circulating cell-free DNA (cfDNA), plasma, report of risk score for advanced adenoma or colorectal cancer |
| 0369U | IADNA GI PTHGN 31 ORG&21 ARG | Description: Infectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique |
| 0370U | IADNA SURG WND PTHGN 34&21 | Description: Infectious agent detection by nucleic acid (DNA and RNA), surgical wound pathogens, 34 microorganisms and identification of 21 associated antibioticresistance genes, multiplex amplified probe technique, wound swab |
| 0371U | IADNA GU PTHGN SEMIQ DNA16&1 | Description: Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogen, semiquantitative identification, DNA from 16 bacterial organisms and 1 fungal organism, multiplex amplified probe technique via quantitative polymerase chain reaction (qPCR), urine |
| 0372U | NFCT DS GU PTHGN ARG DETCJ | Description: Infectious disease (genitourinary pathogens), antibiotic-resistance gene detection, multiplex amplified probe technique, urine, reported as an antimicrobial stewardship risk score |
| 0373U | IADNA RSP TR NFCT 17 8 13&16 | Description: Infectious agent detection by nucleic acid (DNA and RNA), respiratory tract infection, 17 bacteria, 8 fungus, 13 virus, and 16 antibiotic-resistance genes, multiplex amplified probe technique, upper or lower respiratory specimen |
| 0374U | IADNA GU PTHGN 21 ORG&21ARG | Description: Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 21 bacterial and fungal organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, urine |
| 0375U | ONC OVRN BCHM ASY 7 PRTN ALG | Description: Oncology (ovarian), biochemical assays of 7 proteins (follicle stimulating hormone, human epididymis protein 4, apolipoprotein A-1, transferrin, beta-2 macroglobulin, prealbumin [ie, transthyretin], and cancer antigen 125), algorithm reported as ovarian cancer risk score |
| 0376U | ONC PRST8 CA IMG ALYS 128 | Description: U Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prostate cancerspecific mortality, includes predictive algorithm to androgen deprivationtherapy response, if appropriate |
| 0377U | CV DS QUAN ADVSRM/PLSM LPRTN | Description: Cardiovascular disease, quantification of advanced serum or plasma lipoprotein profile, by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (including 23 variables) |
| 0378U | RFC1 REPEAT XPNSJ VRNT ALYS | Description: RFC1 (replication factor C subunit 1), repeat expansion variant analysis by traditional and repeat-primed PCR, blood, saliva, or buccal swab |
| 0379U | TGSAP SL OR NEO DNA523&RNA55 | Description: Targeted genomic sequence analysis panel, solid organ neoplasm, DNA (523 genes) and RNA (55 genes) by nextgeneration sequencing, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability, and tumor mutational burden |
| 0380U | RX METB ADVRS TRGT SQ ALY 20 | Description: Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis, 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and phenotype |
| 0381U | MAPLE SYRUP UR DS MNTR QUAN | Description: Maple syrup urine disease monitoring by patient-collected blood card sample, quantitative measurement of alloisoleucine, leucine, isoleucine, and valine, liquid chromatography with tandem mass spectrometry (LCMS/MS) |
| 0382U | HYPRPHENYLALNINMIA MNTR QUAN | Description: Hyperphenylalaninemia monitoring by patient-collected blood card sample, quantitative measurement of phenylalanine and tyrosine, liquid chromatography with tandem mass spectrometry (LC-MS/MS) |
| 0383U | TYROSINEMIA TYP I MNTR QUAN | Description: Tyrosinemia type I monitoring by patient-collected blood card sample, quantitative measurement of tyrosine, phenylalanine, methionine, succinylacetone, nitisinone, liquid chromatography with tandem mass spectrometry (LC-MS/MS) |
| 0384U | NEPH CKD RSK HI STG KDN DS | Description: Nephrology (chronic kidney disease), carboxymethyllysine, methylglyoxal hydroimidazolone, and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LCMS/MS) and HbA1c and estimated glomerular filtration rate (GFR), with risk score reported for predictive progression to high-stage kidney disease |
| 0385U | NEPH CKD ALG RSK DBTC KDN DS | Description: U Nephrology (chronic kidney disease), apolipoprotein A4 (ApoA4), CD5 antigen-like (CD5L), and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay (ELISA), plasma, algorithm combining results with HDL, estimated glomerular filtration rate (GFR) and clinical data reported as a risk score for developing diabetic kidney disease |
| 0386U | GI BARRETT ESOPH MTHYLTN ALY | Description: U Gastroenterology (Barrett’s esophagus), P16, RUNX3, HPP1, and FBN1 methylation analysis, prognostic and predictive algorithm reported as a risk score for progression to high-grade dysplasia or esophageal cancer |
| A4397 | Irrigation supply sleeve | Description: Irrigation supply; sleeve, each |
| A4466 | Elastic garment/covering | Description: Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each |
| A7011 | Nondispos corrugated tubing | Description: Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet |
| A7042 | Implanted pleural catheter | Description: Implanted pleural catheter, each |
| A7043 | Vacuum drainagebottle/tubing | Description: Vacuum drainage bottle and tubing for use with implanted catheter |
| A9544 | I131 tositumomab, dx | Description: Iodine i-131 tositumomab, diagnostic, per study dose |
| A9545 | I131 tositumomab, rx | Description: Iodine i-131 tositumomab, therapeutic, per treatment dose |
| A9599 | Radioph dx b amyloid pet nos | Description: Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified |
| B9000 | Enter infusion pump w/o alrm | Description: Enteral nutrition infusion pump - without alarm |
| C1300 | Hyperbaric oxygen | Description: Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval |
| C1834 | Pressure sensor system, im | Description: Pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software application |
| C1841 | Retinal prosth int/ext comp | Description: Retinal prosthesis, includes all internal and external components |
| C1842 | Retinal prosth, add-on | Description: Retinal prosthesis, includes all internal and external components; add-on to c1841 |
| C1849 | Skin substitute, synthetic | Description: Skin substitute, synthetic, resorbable, per square centimeter |
| C8904 | Mri w/o cont, breast, uni | Description: Magnetic resonance imaging without contrast, breast; unilateral |
| C8907 | Mri w/o cont, breast, bi | Description: Magnetic resonance imaging without contrast, breast; bilateral |
| C9014 | Injection, cerliponase alfa | Description: Injection, cerliponase alfa, 1 mg |
| C9015 | C-1 esterase, haegarda | Description: Injection, c-1 esterase inhibitor (human), haegarda, 10 units |
| C9016 | Inj, triptorelin ext rel | Description: Injection, triptorelin extended release, 3.75 mg |
| C9021 | Injection, obinutuzumab | Description: Injection, obinutuzumab, 10 mg |
| C9022 | Injection, elosulfase alfa | Description: Injection, elosulfase alfa, 1mg |
| C9023 | Inj testosterone undecanoate | Description: Injection, testosterone undecanoate, 1 mg |
| C9024 | Inj, daunorubicin-cytarabine | Description: Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine |
| C9025 | Injection, ramucirumab | Description: Injection, ramucirumab, 5 mg |
| C9026 | Injection, vedolizumab | Description: Injection, vedolizumab, 1 mg |
| C9027 | Injection, pembrolizumab | Description: Injection, pembrolizumab, 1 mg |
| C9028 | Inj. inotuzumab ozogamicin | Description: Injection, inotuzumab ozogamicin, 0.1 mg |
| C9029 | Injection, guselkumab | Description: Injection, guselkumab, 1 mg |
| C9030 | Inj copanlisib | Description: Injection, copanlisib, 1 mg |
| C9031 | Lutetium lu 177 dotatate, tx | Description: Lutetium lu 177, dotatate, therapeutic, 1 mci |
| C9032 | Voretigene neparvovec-rzyl | Description: Injection, voretigene neparvovec-rzyl, 1 billion vector genome |
| C9033 | Inj, akynzeo | Description: Injection, fosnetupitant 235 mg and palonosetron 0.25 mg |
| C9034 | Injection, dexamethasone 9% | Description: Injection, dexamethasone 9%, intraocular, 1 mcg |
| C9035 | Injection, aristada initio | Description: Injection, aripiprazole lauroxil (aristada initio), 1 mg |
| C9036 | Injection, patisiran | Description: Injection, patisiran, 0.1 mg |
| C9037 | Injection, risperidone | Description: Injection, risperidone (perseris), 0.5 mg |
| C9038 | Inj mogamulizumab-kpkc | Description: Injection, mogamulizumab-kpkc, 1 mg |
| C9039 | Injection, plazomicin | Description: Injection, plazomicin, 5 mg |
| C9040 | Injection, fremanezumab-vfrm | Description: Injection, fremanezumab-vfrm, 1mg |
| C9041 | Inj, coagulation factor xa | Description: Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg |
| C9042 | Inj., belrapzo 1 mg | Description: Injection, bendamustine hcl (belrapzo), 1 mg |
| C9043 | Injection, levoleucovorin | Description: Injection, levoleucovorin, 1 mg |
| C9044 | Injection, cemiplimab-rwlc | Description: Injection, cemiplimab-rwlc, 1 mg |
| C9045 | Moxetumomab pasudotox-tdfk | Description: Injection, moxetumomab pasudotox-tdfk, 0.01 mg |
| C9048 | Dexamethasone ophth insert | Description: Dexamethasone, lacrimal ophthalmic insert, 0.1 mg |
| C9049 | Injection, tagraxofusp-erzs | Description: Injection, tagraxofusp-erzs, 10 mcg |
| C9050 | Injection, emapalumab-lzsg | Description: Injection, emapalumab-lzsg, 1 mg |
| C9051 | Injection, omadacycline | Description: Injection, omadacycline, 1 mg |
| C9052 | Injection, ravulizumab-cwv | Description: Injection, ravulizumab-cwvz, 10 mg |
| C9053 | Inj, crizanlizumab-tmca | Description: Injection, crizanlizumab-tmca, 1 mg |
| C9054 | Injection, lefamulin | Description: Injection, lefamulin (xenleta), 1 mg |
| C9055 | Inj, brexanolone | Description: Injection, brexanolone, 1mg |
| C9056 | Injection, givosiran | Description: Injection, givosiran, 0.5 mg |
| C9057 | Inj cetirizine hydrochloride | Description: Injection, cetirizine hydrochloride, 1 mg |
| C9058 | Injection,pegfilgrastim-bmez | Description: Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg |
| C9059 | Injection, meloxicam | Description: Injection, meloxicam, 1 mg |
| C9060 | Fluoroestradiol f18 | Description: Fluoroestradiol f18, diagnostic, 1 mci |
| C9061 | Injection, teprotumumab-trbw | Description: Injection, teprotumumab-trbw, 10 mg |
| C9062 | Daratumumab hyaluronidase | Description: Injection, daratumumab 10 mg and hyaluronidase-fihj |
| C9063 | Injection, eptinezumab-jjmr | Description: Injection, eptinezumab-jjmr, 1 mg |
| C9064 | Mitomycin pyelocalyceal inst | Description: Mitomycin pyelocalyceal instillation, 1 mg |
| C9065 | Romidepsin non-lyophilized | Description: Injection, romidepsin, non-lyophilized (e.g. liquid), 1mg |
| C9066 | Sacituzumab govitecan-hziy | Description: Injection, sacituzumab govitecan-hziy, 2.5 mg |
| C9068 | Copper cu-64, dotatate, dx | Description: Copper cu-64, dotatate, diagnostic, 1 millicurie |
| C9069 | Belantamab mafodontin-blmf | Description: Injection, belantamab mafodontin-blmf, 0.5 mg |
| C9070 | Injection, tafasitamab-cxix | Description: Injection, tafasitamab-cxix, 2 mg |
| C9071 | Injection, viltolarsen | Description: Injection, viltolarsen, 10 mg |
| C9072 | Inj, imm glob asceniv | Description: Injection, immune globulin (asceniv), 500 mg |
| C9073 | Brexucabtagene autoleucel ca | Description: Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| C9074 | Injection, lumasiran | Description: Injection, lumasiran, 0.5 mg |
| C9075 | Injection, casimersen, 10 mg | Description: Injection, casimersen, 10 mg |
| C9076 | Lisocabtagene car pos t | Description: Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| C9077 | Inj cabotegravir/rilpivirine | Description: Injection, cabotegravir and rilpivirine, 2mg/3mg |
| C9078 | Inj, trilaciclib, 1 mg | Description: Injection, trilaciclib, 1 mg |
| C9079 | Inj, evinacumab-dgnb, 5 mg | Description: Injection, evinacumab-dgnb, 5 mg |
| C9080 | Inj, melphalan flufen, 1 mg | Description: Injection, melphalan flufenamide hydrochloride, 1 mg |
| C9081 | Idecabtagene car pos t | Description: Idecabtagene vicleucel, up to 460 million autologous anti-bcma car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| C9082 | Inj dostarlimab-gxly, 100 mg | Description: Injection, dostarlimab-gxly, 100 mg |
| C9083 | Inj, amivantamab-vmjw, 10 mg | Description: Injection, amivantamab-vmjw, 10 mg |
| C9084 | Loncastuximab-lpyl, 0.1 mg | Description: Injection, loncastuximab tesirine-lpyl, 0.1 mg |
| C9085 | Inj avalglucosid alfa-ngpt | Description: Injection, avalglucosidase alfa-ngpt, 4 mg |
| C9086 | Inj, anifrolumab-fnia | Description: Injection, anifrolumab-fnia, 1 mg |
| C9087 | Inj cyclophosphamd auromedic | Description: Injection, cyclophosphamide, (auromedics), 10 mg |
| C9090 | Plasminogen, human-tvmh 1 mg | Description: Injection, plasminogen, human-tvmh, 1 mg |
| C9091 | Sirolimus, protein-bound,1mg | Description: Injection, sirolimus protein-bound particles, 1 mg |
| C9092 | Inj., xipere, 1 mg | Description: Injection, triamcinolone acetonide, suprachoroidal (xipere), 1 mg |
| C9093 | Inj., susvimo, 0.1 mg | Description: Injection, ranibizumab, via sustained release intravitreal implant (susvimo), 0.1 mg |
| C9094 | Inj, sutimlimab-jome, 10 mg | Description: Inj, sutimlimab-jome, 10 mg |
| C9095 | Inj, tebentafusp-tebn, 1 mcg | Description: Inj, tebentafusp-tebn, 1 mcg |
| C9096 | Inj, releuko, 1 mcg | Description: Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram |
| C9097 | Inj, faricimab-svoa, 0.1 mg | Description: Inj, faricimab-svoa, 0.1 mg |
| C9098 | Ciltacabtagene car pos t | Description: Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| C9121 | Injection, argatroban | Description: Injection, argatroban, per 5 mg |
| C9122 | Mometasone furoate (sinuva) | Description: Mometasone furoate sinus implant, 10 micrograms (sinuva) |
| C9132 | Kcentra, per i.u. | Description: Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity |
| C9133 | Factor ix recombinant | Description: Factor ix (antihemophilic factor, recombinant), rixubis, per i.u. |
| C9134 | Factor xiii a-subunit recomb | Description: Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u. |
| C9135 | Factor ix (alprolix) | Description: Factor ix (antihemophilic factor, recombinant), alprolix, per i.u. |
| C9136 | Factor viii (eloctate) | Description: Injection, factor viii, fc fusion protein, (recombinant), per i.u. |
| C9137 | Adynovate factor viii recom | Description: Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u. |
| C9138 | Nuwiq factor viii recomb | Description: Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u. |
| C9139 | Idelvion, 1 i.u. | Description: Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u. |
| C9140 | Afstyla factor viii recomb | Description: Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u. |
| C9141 | Factor viii pegylated-aucl | Description: Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u. |
| C9142 | Inj, alymsys, 10 mg | Description: Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg |
| C9146 | Inj, elahere, 1 mg | Description: Injection, mirvetuximab soravtansine-gynx, 1 mg |
| C9147 | Inj, tremelimumab-actl, 1 mg | Description: Injection, tremelimumab-actl, 1 mg |
| C9148 | Inj, teclistamab-cqyv, 0.5mg | Description: Injection, teclistamab-cqyv, 0.5 mg |
| C9149 | Inj, teplizumab-mzwv, 5 mcg | Description: Injection, teplizumab-mzwv, 5 mcg |
| C9151 | Inj, pegcetacoplan 1 mg | Description: Injection, pegcetacoplan, 1 mg |
| C9152 | Inj, abilify asimtufii, 1 mg | Description: Injection, aripiprazole, (abilify asimtufii), 1 mg |
| C9153 | Inj, amisulpride, 1 mg | Description: Injection, amisulpride, 1 mg |
| C9154 | Inj buprenorph (brixadi) 1mg | Description: Injection, buprenorphine extended-release (brixadi), 1 mg |
| C9155 | Inj epcoritamab-bysp,0.16 mg | Description: Injection, epcoritamab-bysp, 0.16 mg |
| C9156 | Flotufolastat f18, dia 1 mci | Description: Flotufolastat f 18, diagnostic, 1 millicurie |
| C9157 | Inj, tofersen, 1 mg | Description: Injection, tofersen, 1 mg |
| C9158 | Inj, uzedy, 1 mg | Description: Injection, risperidone, (uzedy), 1 mg |
| C9275 | Hexaminolevulinate hcl | Description: Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose |
| C9349 | Puraply, puraply antimic | Description: Puraply, and puraply antimicrobial, any type, per square centimeter |
| C9407 | Iodine i-131 iobenguane, dx | Description: Iodine i-131 iobenguane, diagnostic, 1 millicurie |
| C9408 | Iodine i-131 iobenguane, tx | Description: Iodine i-131 iobenguane, therapeutic, 1 millicurie |
| C9441 | Inj, ferric carboxymaltose | Description: Injection, ferric carboxymaltose, 1 mg |
| C9442 | Injection, belinostat | Description: Injection, belinostat, 10 mg |
| C9443 | Injection, dalbavancin | Description: Injection, dalbavancin, 10 mg |
| C9444 | Injection, oritavancin | Description: Injection, oritavancin, 10 mg |
| C9445 | C-1 esterase, ruconest | Description: Injection, c-1 esterase inhibitor (recombinant), ruconest, 10 units |
| C9446 | Inj, tedizolid phosphate | Description: Injection, tedizolid phosphate, 1 mg |
| C9447 | Inj, phenylephrine ketorolac | Description: Injection, phenylephrine and ketorolac, 4 ml vial |
| C9448 | Oral netupitant palonosetron | Description: Netupitant 300 mg and palonosetron 0.5 mg, oral |
| C9449 | Inj, blinatumomab | Description: Injection, blinatumomab, 1 mcg |
| C9450 | Fluocinolone acetonide implt | Description: Injection, fluocinolone acetonide intravitreal implant, 0.01 mg |
| C9451 | Injection, peramivir | Description: Injection, peramivir, 1 mg |
| C9452 | Inj, ceftolozane/tazobactam | Description: Injection, ceftolozane 50 mg and tazobactam 25 mg |
| C9453 | Injection, nivolumab | Description: Injection, nivolumab, 1 mg |
| C9454 | Inj, pasireotide long acting | Description: Injection, pasireotide long acting, 1 mg |
| C9455 | Injection, siltuximab | Description: Injection, siltuximab, 10 mg |
| C9456 | Inj, isavuconazonium sulfate | Description: Injection, isavuconazonium sulfate, 1 mg |
| C9457 | Lumason contrast agent | Description: Injection, sulfur hexafluoride lipid microsphere, per ml |
| C9458 | Florbetaben f18 | Description: Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries |
| C9459 | Flutemetamol f18 | Description: Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries |
| C9461 | Choline c 11, diagnostic | Description: Choline c 11, diagnostic, per study dose |
| C9463 | Injection, aprepitant | Description: Injection, aprepitant, 1 mg |
| C9464 | Injection, rolapitant | Description: Injection, rolapitant, 0.5 mg |
| C9465 | Injection, durolane | Description: Hyaluronan or derivative, durolane, for intra-articular injection, per dose |
| C9466 | Injection, benralizumab | Description: Injection, benralizumab, 1 mg |
| C9467 | Inj rituximab hyaluronidase | Description: Injection, rituximab and hyaluronidase, 10 mg |
| C9468 | Inj, factor ix, rebinyn | Description: Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u. |
| C9469 | Inj triamcinolone acetonide | Description: Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg |
| C9470 | Aripiprazole lauroxil im | Description: Injection, aripiprazole lauroxil, 1 mg |
| C9471 | Hymovis, 1 mg | Description: Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg |
| C9472 | Inj talimogene laherparepvec | Description: Injection, talimogene laherparepvec, 1 million plaque forming units (pfu) |
| C9473 | Injection, mepolizumab | Description: Injection, mepolizumab, 1 mg |
| C9474 | Inj, irinotecan liposome | Description: Injection, irinotecan liposome, 1 mg |
| C9475 | Injection, necitumumab | Description: Injection, necitumumab, 1 mg |
| C9476 | Injection, daratumumab | Description: Injection, daratumumab, 10 mg |
| C9477 | Injection, elotuzumab | Description: Injection, elotuzumab, 1 mg |
| C9478 | Injection, sebelipase alfa | Description: Injection, sebelipase alfa, 1 mg |
| C9479 | Instill, ciprofloxacin otic | Description: Instillation, ciprofloxacin otic suspension, 6 mg |
| C9480 | Injection, trabectedin | Description: Injection, trabectedin, 0.1 mg |
| C9481 | Injection, reslizumab | Description: Injection, reslizumab, 1 mg |
| C9483 | Injection, atezolizumab | Description: Injection, atezolizumab, 10 mg |
| C9484 | Injection, eteplirsen | Description: Injection, eteplirsen, 10 mg |
| C9485 | Injection, olaratumab | Description: Injection, olaratumab, 10 mg |
| C9486 | Inj, granisetron ext | Description: Injection, granisetron extended release, 0.1 mg |
| C9487 | Ustekinumab iv inj, 1 mg | Description: Ustekinumab, for intravenous injection, 1 mg |
| C9489 | Injection, nusinersen | Description: Injection, nusinersen, 0.1 mg |
| C9490 | Injection, bezlotoxumab | Description: Injection, bezlotoxumab, 10 mg |
| C9491 | Injection, avelumab | Description: Injection, avelumab, 10 mg |
| C9492 | Injection, durvalumab | Description: Injection, durvalumab, 10 mg |
| C9493 | Injection, edaravone | Description: Injection, edaravone, 1 mg |
| C9494 | Injection, ocrelizumab | Description: Injection, ocrelizumab, 1 mg |
| C9497 | Loxapine, inhalation powder | Description: Loxapine, inhalation powder, 10 mg |
| C9724 | Eps stomach plic | Description: Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopy |
| C9735 | Anoscopy, submucosal inj | Description: Anoscopy; with directed submucosal injection(s), any substance |
| C9737 | Lap esoph augmentation | Description: Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band) |
| C9741 | Impl pressure sensor w/angio | Description: Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report |
| C9742 | Laryngoscopy with injection | Description: Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed |
| C9743 | Bulking/spacer material impl | Description: Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) |
| C9744 | Abd us w/contrast | Description: Ultrasound, abdominal, with contrast |
| C9745 | Nasal endo eustachian tube | Description: Nasal endoscopy, surgical; balloon dilation of eustachian tube |
| C9746 | Trans imp balloon cont | Description: Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed |
| C9747 | Ablation, hifu, prostate | Description: Ablation of prostate, transrectal, high intensity focused ultrasound (hifu), including imaging guidance |
| C9748 | Prostatic rf water vapor tx | Description: Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy |
| C9749 | Repair nasal stenosis w/imp | Description: Repair of nasal vestibular lateral wall stenosis with implant(s) |
| C9750 | Ins/rem-replace compl iims | Description: Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation and peri-operative interrogation and programming; complete system (includes device and electrode) |
| C9752 | Intraosseous des lumb/sacrum | Description: Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum |
| C9753 | Intraosseous destruct add'l | Description: Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure) |
| C9754 | Perc av fistula, direct | Description: Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed) |
| C9755 | Rf magnetic-guide av fistula | Description: Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed |
| C9770 | Vitrec/mech pars, subret inj | Description: Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent |
| C9771 | Nsl/sins cryo post nasal tis | Description: Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral |
| C9788 | Uni breas optoacoustic imag | Description: Opto-acoustic imaging, breast (including axilla when performed), unilateral, with image documentation, analysis and report, obtained with ultrasound examination |
| C9800 | Dermal filler inj px/suppl | Description: Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies |
| C9803 | Hopd covid-19 spec collect | Description: Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
| E0450 | Vol control vent invasiv int | Description: Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube) |
| E0460 | Neg press vent portabl/statn | Description: Negative pressure ventilator; portable or stationary |
| E0461 | Vol control vent noninv int | Description: Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask) |
| E0463 | Press supp vent invasive int | Description: Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube) |
| E0464 | Press supp vent noninv int | Description: Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (e.g., mask) |
| E0628 | Seat lift for pt furn-electr | Description: Separate seat lift mechanism for use with patient owned furniture-electric |
| G0028 | Doc med rsn no scr tob | Description: Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason) |
| G0056 | Opt chronic dx mang mvp | Description: Optimizing chronic disease management mips value pathways |
| G0154 | Hhcp-svs of rn,ea 15 min | Description: Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes |
| G0163 | Hhc lpn/rn obs/asses ea 15 | Description: Skilled 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 possible modification of treatment in the home health or hospice setting) |
| G0164 | Hhc lis nurse train ea 15 | Description: Skilled 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 minutes |
| G0173 | Linear acc stereo radsur com | Description: Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session |
| G0202 | Scr mammo bi incl cad | Description: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed |
| G0204 | Dx mammo incl cad bi | Description: Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral |
| G0206 | Dx mammo incl cad uni | Description: Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral |
| G0251 | Linear acc based stero radio | Description: Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment |
| G0297 | Ldct for lung ca screen | Description: Low dose ct scan (ldct) for lung cancer screening |
| G0308 | 180 d implant glucose sensor | Description: Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training |
| G0309 | Rem/inser glu sensor dif sit | Description: Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation |
| G0364 | Bone marrow aspirate &biopsy | Description: Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service |
| G0365 | Vessel mapping hemo access | Description: Vessel 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) |
| G0389 | Ultrasound exam aaa screen | Description: Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening |
| G0417 | Sat biopsy prostate 21-40 | Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens |
| G0418 | Sat biopsy prostate 41-60 | Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens |
| G0419 | Sat biopsy prostate: >60 | Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens |
| G0424 | Pulmonary rehab w exer | Description: Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day |
| G0431 | Drug screen multiple class | Description: Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter |
| G0434 | Drug screen multi drug class | Description: Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter |
| G0436 | Tobacco-use counsel 3-10 min | Description: Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes |
| G0437 | Tobacco-use counsel>10min | Description: Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes |
| G0456 | Neg pre wound <=50 sq cm | Description: Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters |
| G0457 | Neg pres wound >50 sq cm | Description: Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters |
| G0461 | Immunohisto/cyto chem 1st st | Description: Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain |
| G0462 | Immunohisto/cyto chem add | Description: Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) |
| G0464 | Colorec ca scr, sto bas dna | Description: Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3) |
| G0477 | Drug test presump optical | Description: Drug 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 performed, per date of service |
| G0478 | Drug test presump opt inst | Description: Drug 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, per date of service |
| G0479 | Drug test presump not opt | Description: Drug 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 when performed, per date of service |
| G0502 | Init psych care manag, 70min | Description: Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies |
| G0503 | Subseq psych care man,60mi | Description: Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment |
| G0504 | Init/sub psych care add 30 m | Description: Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503) |
| G0505 | Cog/func assessment outpt | Description: Cognition 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 domiciliary or rest home |
| G0507 | Care manage serv minimum 20 | Description: Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team |
| G0515 | Cognitive skills development | Description: Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes |
| G0908 | Hgb > 12 g/dl | Description: Most recent hemoglobin (hgb) level > 12.0 g/dl |
| G0909 | Hbg not doc | Description: Hemoglobin level measurement not documented, reason not given |
| G0910 | Hgb <= 12 g/dl | Description: Most recent hemoglobin level <= 12.0 g/dl |
| G0919 | Flu immunize not avail | Description: Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit |
| G0920 | Type loc act doc | Description: Type, anatomic location, and activity all documented |
| G0921 | Doc pt reas no assess | Description: Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment) |
| G0922 | Type loc act not doc | Description: No documentation of disease type, anatomic location, and activity, reason not given |
| G1000 | Cdsm applied pathways | Description: Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program |
| G1005 | Cdsm nia | Description: Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program |
| G1006 | Cdsm test approp | Description: Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program |
| G1009 | Cdsm sage health | Description: Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program |
| G2023 | Specimen collect covid-19 | Description: Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
| G2024 | Spec coll snf/lab covid-19 | Description: Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source |
| G2058 | Ccm add 20min | Description: Chronic 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 g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). |
| G2061 | Qual nonmd est pt 5-10m | Description: Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes |
| G2062 | Qual nonmd est pt 11-20m | Description: Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes |
| G2063 | Qual nonmd est pt 21>min | Description: Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes |
| G2064 | Md mang high risk dx 30 | Description: Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities |
| G2065 | Clin mang h risk dx 30 | Description: Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities |
| G2066 | Inter devc remote 30d | Description: Interrogation 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 technician review, technical support and distribution of results |
| G2089 | A1c level 7 to 9% | Description: Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0% |
| G2095 | Sys rsn no ace arn arni | Description: Documentation of system reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., other system reasons) |
| G2102 | Dil retinal eye exam | Description: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed |
| G2103 | 7 stereo photos interpret | Description: Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed |
| G2104 | Eye img valid w/7 stereo | Description: Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed |
| G2108 | Pt 66+ snp or ltc pos > 90d | Description: Patient 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 consecutive days during the measurement period |
| G2109 | Pt 66+ frailty and med dem | Description: Patients 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 period |
| G2110 | Pt 66+ frailty and adv ill | Description: Patients 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 encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2114 | Pt 66-80 frailty and med dem | Description: Patients 66-80 years of age 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 period |
| G2117 | Pt 66-80 frailty and adv ill | Description: Patients 66-80 years of age 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 encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2119 | Calc vitd opt | Description: Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed |
| G2120 | No calc vitd opt | Description: Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performed |
| G2123 | Pt 66-80 frailty med dem | Description: Patients 66-80 years of age and had 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 encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2124 | Pt 66-80 frailty adv ill | Description: Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication |
| G2130 | Pt 66+ lt inst > 90 | Description: Patients 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 period |
| G2131 | Pt 81+ frailty | Description: Patients 81 years and older with a diagnosis of frailty |
| G2132 | Pt 66-80 frailty and med dem | Description: Patients 66-80 years of age 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 period |
| G2133 | Pt 66-80 frailty and adv ill | Description: Patients 66-80 years of age 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 encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2134 | Pt 66+ frailty and med dem | Description: Patients 66 years of age or 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 period |
| G2135 | Pt 66+ frailty and adv ill | Description: Patients 66 years of age or 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 encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2153 | Hosp dur meas pd | Description: In hospice or using hospice services during the measurement period |
| G2154 | Td 9 yrs start end meas | Description: Patient received at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period |
| G2155 | Hist contraindications | Description: Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.) |
| G2156 | No prior td or hx contra | Description: Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.) |
| G2157 | Pneum vacc 12 mo 60+ | Description: Patients received both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during the measurement period |
| G2158 | Pneum vacc adv rx | Description: Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period |
| G2159 | No pneum vacc 12 mo 60+ | Description: Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period |
| G2160 | Herpzos 50+ | Description: Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period |
| G2161 | Adv rx zos | Description: Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period |
| G2162 | No herpzos 50+ | Description: Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period |
| G2163 | Infl vacc 07/01 to 06/30 | Description: Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period |
| G2164 | Adv rx infl vacc | Description: Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period |
| G2165 | No infl vacc 07/01 to 06/30 | Description: Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period |
| G2166 | No pt adm dx no neck fs prom | Description: Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason |
| G2170 | Avf by tissue w thermal e | Description: Percutaneous 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, and includes all imaging and radiologic guidance, supervision and interpretation, when performed |
| G2171 | Avf use magnetic/art/ven | Description: Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed |
| G2198 | Med rsn no unhlthy etoh | Description: Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons) |
| G2201 | Med rsn no brief couns | Description: Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons) |
| G2203 | Med rsn no etoh couns | Description: Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons) |
| G3001 | Admin + supply, tositumomab | Description: Administration and supply of tositumomab, 450 mg |
| G6018 | Ileoscopy w/stent | Description: Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation) |
| G6019 | Colonoscopy lesion removal | Description: Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
| G6020 | Colonoscopy w/stent | Description: Colonoscopy through stoma; with transendoscopic stent placement (includes predilation) |
| G6021 | Unlisted px small intestine | Description: Unlisted procedure, intestine |
| G6022 | Sigmoidoscopy w/ablate tumr | Description: Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
| G6023 | Sigmoidoscopy w/stent | Description: Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation) |
| G6024 | Lesion removal colonoscopy | Description: Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
| G6025 | Colonoscopy w/stent | Description: Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation) |
| G6027 | Anoscopy hra w/spec collect | Description: Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed |
| G6028 | Anoscopy hra w/biopsy | Description: Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies) |
| G6030 | Assay of amitriptyline | Description: Amitriptyline |
| G6031 | Assay of benzodiazepines | Description: Benzodiazepines |
| G6032 | Assay of desipramine | Description: Desipramine |
| G6034 | Assay of doxepin | Description: Doxepin |
| G6035 | Assay of gold | Description: Gold |
| G6036 | Assay of imipramine | Description: Assay of imipramine |
| G6037 | Assay of nortiptyline | Description: Nortriptyline |
| G6038 | Assay of salicylate | Description: Salicylate |
| G6039 | Assay of acetaminophen | Description: Acetaminophen |
| G6040 | Assay of ethanol | Description: Alcohol (ethanol); any specimen except breath |
| G6041 | Assay of urine alkaloids | Description: Alkaloids, urine, quantitative |
| G6042 | Assay of amphetamines | Description: Amphetamine or methamphetamine |
| G6043 | Assay of barbiturates | Description: Barbiturates, not elsewhere specified |
| G6044 | Assay of cocaine | Description: Cocaine or metabolite |
| G6045 | Assay of dihydrocodeinone | Description: Dihydrocodeinone |
| G6046 | Assay of dihydromorphinone | Description: Dihydromorphinone |
| G6047 | Assay of dihydrotestosterone | Description: Dihydrotestosterone |
| G6048 | Assay of dimethadione | Description: Dimethadione |
| G6049 | Asssay of epiandrosterone | Description: Epiandrosterone |
| G6050 | Assay of ethchlorvynol | Description: Ethchlorvynol |
| G6051 | Assay of flurazepam | Description: Flurazepam |
| G6052 | Assay of meprobamate | Description: Meprobamate |
| G6053 | Assay of methadone | Description: Methadone |
| G6054 | Assay of methsuximide | Description: Methsuximide |
| G6055 | Assay of nicotine | Description: Nicotine |
| G6056 | Assay of opiates | Description: Opiate(s), drug and metabolites, each procedure |
| G6057 | Assay of phenothiazine | Description: Phenothiazine |
| G6058 | Drug confirmation | Description: Drug confirmation, each procedure |
| G8126 | Pt treat w/antidepress12wks | Description: Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase |
| G8127 | Pt not treat w/antidepres12w | Description: Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase |
| G8128 | Pt inelig for antidepres med | Description: Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure |
| G8398 | Dil macular/fundus not perfo | Description: Dilated macular or fundus exam not performed |
| G8401 | Pt inelig osteo screen measu | Description: Clinician documented that patient was not an eligible candidate for screening |
| G8406 | Pt inelig lower extrem neuro | Description: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure |
| G8422 | Pt inelig bmi calculation | Description: Bmi not documented, documentation the patient is not eligible for bmi calculation |
| G8442 | Doc pain as nt perf, not elg | Description: Pain 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 encounter |
| G8458 | Pt inelig geno no antvir tx | Description: Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment) |
| G8460 | Pt inelig rna no antvir tx | Description: Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c |
| G8461 | Pt rec antivir treat hep c | Description: Patient receiving antiviral treatment for hepatitis c during the measurement period |
| G8464 | Pt inelig; lo to no dter rsk | Description: Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined |
| G8485 | Report, diabetes measures | Description: I intend to report the diabetes mellitus (dm) measures group |
| G8486 | Report, prev care measures | Description: I intend to report the preventive care measures group |
| G8487 | Report ckd measures | Description: I intend to report the chronic kidney disease (ckd) measures group |
| G8489 | Cad measures grp | Description: I intend to report the coronary artery disease (cad) measures group |
| G8490 | Ra measures grp | Description: I intend to report the rheumatoid arthritis (ra) measures group |
| G8491 | Hiv/aids measures grp | Description: I intend to report the hiv/aids measures group |
| G8492 | Periop care measures grp | Description: I intend to report the perioperative care measures group |
| G8493 | Back pain measures grp | Description: I intend to report the back pain measures group |
| G8494 | Dm meas qual act perform | Description: All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient |
| G8495 | Ckd meas qual act perform | Description: All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient |
| G8496 | Prev care mg qual act perfrm | Description: All quality actions for the applicable measures in the preventive care measures group have been performed for this patient |
| G8497 | Cabg meas qual act perform | Description: All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient |
| G8498 | Cad meas qual act perform | Description: All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient |
| G8499 | Ra meas qual act perform | Description: All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient |
| G8500 | Hiv meas qual act perform | Description: All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient |
| G8501 | Perio meas qual act perform | Description: All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient |
| G8502 | Back pain mg qual act perfrm | Description: All quality actions for the applicable measures in the back pain measures group have been performed for this patient |
| G8506 | Pt rec ace/arb | Description: Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
| G8509 | Pos pain assess no f/u doc | Description: Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given |
| G8530 | Auto av fistula recd | Description: Autogenous av fistula received |
| G8531 | Pt inelig; auto av fistula | Description: Clinician documented that patient was not an eligible candidate for autogenous av fistula |
| G8532 | No auto av fistula; no reas | Description: Clinician documented that patient received vascular access other than autogenous av fistula, reason not given |
| G8544 | Cabg measures grp | Description: I intend to report the coronary artery bypass graft (cabg) measures group |
| G8545 | Hepc measures grp | Description: I intend to report the hepatitis c measures group |
| G8547 | Ivd measures grp | Description: I intend to report the ischemic vascular disease (ivd) measures group |
| G8548 | Hf measures grp | Description: I intend to report the heart failure (hf) measures group |
| G8549 | Hepc mg qual act perform | Description: All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient |
| G8551 | Hf mg qual act perform | Description: All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient |
| G8552 | Ivd mg qual act perform | Description: All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient |
| G8571 | Ster wd ifx 30 d postop | Description: Development of deep sternal wound infection/mediastinitis within 30 days postoperatively |
| G8572 | No ster wd ifx | Description: No deep sternal wound infection/mediastinitis |
| G8573 | Stk cabg | Description: Stroke following isolated cabg surgery |
| G8574 | No strk cabg | Description: No stroke following isolated cabg surgery |
| G8579 | Antplt med disch | Description: Antiplatelet medication at discharge |
| G8580 | Antplt med contraind | Description: Antiplatelet medication contraindicated |
| G8581 | No antplt med disch | Description: No antiplatelet medication at discharge |
| G8582 | Bblock disch | Description: Beta-blocker at discharge |
| G8583 | Bblock contraind | Description: Beta-blocker contraindicated |
| G8584 | No bblock disch | Description: No beta-blocker at discharge |
| G8585 | Antilipid treat disch | Description: Anti-lipid treatment at discharge |
| G8586 | Antlip disch contra | Description: Anti-lipid treatment contraindicated |
| G8587 | No antlipid treat disch | Description: No anti-lipid treatment at discharge |
| G8593 | Lipid pn results | Description: Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c) |
| G8594 | No lipid prof perf | Description: Lipid profile not performed, reason not given |
| G8595 | Ldl < 100 | Description: Most recent ldl-c < 100 mg/dl |
| G8597 | Ldl >= 100 | Description: Most recent ldl-c >= 100 mg/dl |
| G8627 | Surg proc w/in 30 days | Description: Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence) |
| G8628 | No surg proc w/in 30 days | Description: Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence) |
| G8629 | Doc antibio order b/4 surg | Description: Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required) |
| G8630 | Doc antibio given b/4 surg | Description: Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered |
| G8631 | Pt no elg 4 order antbi give | Description: Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required) |
| G8632 | Doc no antibi order b/4 surg | Description: Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given |
| G8634 | Pt no elg phar ther osteo | Description: Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis |
| G8645 | Asthma measures grp | Description: I intend to report the asthma measures group |
| G8646 | Asthma mg qual act perform | Description: All quality actions for the applicable measures in the asthma measures group have been performed for this patient |
| G8649 | Rafscrs ki no scor | Description: Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8653 | Rafscrs hi no scor | Description: Risk-adjusted functional status change residual scores for the hip impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8657 | Rafscrs llfai no scor | Description: Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8665 | Rafscrs si no scor | Description: Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8669 | Rafscrs | Description: Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8671 | Rafscrs goi scor >= 0 | Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8672 | Rafscrs goi scor < 0 | Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0) |
| G8673 | Rafscrs goi no scor | Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8674 | Rafscrs neck, no msr/no foto | Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given |
| G8682 | Lvg test perf | Description: Lvf testing documented as being performed prior to discharge or in the previous 12 months |
| G8683 | Pt not elig for lvf test | Description: Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason |
| G8685 | Lvf test not perf | Description: Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given |
| G8696 | Antithromb thx presc | Description: Antithrombotic therapy prescribed at discharge |
| G8697 | Antithromb no presc doc reas | Description: Antithrombotic 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)) |
| G8698 | Antithromb no presc no reas | Description: Antithrombotic therapy was not prescribed at discharge, reason not given |
| G8699 | Rehab ordered disch | Description: Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge |
| G8700 | Rehab not indicated disch | Description: Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge |
| G8701 | Rehab not ordered | Description: Rehabilitation services were not ordered, reason not otherwise specified |
| G8702 | Antiobiotics 4 hr prior surg | Description: Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively |
| G8703 | Antibiotics not prior surg | Description: Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively |
| G8704 | Ecg performed | Description: 12-lead electrocardiogram (ecg) performed |
| G8705 | Med reas no ecg | Description: Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg) |
| G8706 | Pt reas no ecg | Description: Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg) |
| G8707 | Ecg not performed | Description: 12-lead electrocardiogram (ecg) not performed, reason not given |
| G8713 | Spkt/v great 1.2 kt/v | Description: Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v]) |
| G8714 | Hemodialysis 3 times week | Description: Hemodialysis treatment performed exactly three times per week for > 90 days |
| G8717 | Less 1.2 kt/v | Description: Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given |
| G8718 | Great 1.7 kt/v per week | Description: Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v]) |
| G8720 | Less 1.7 kt/v per week | Description: Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v]) |
| G8725 | Lipid profile perf doc | Description: Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol) |
| G8726 | Doc reas no lipid profile | Description: Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons) |
| G8728 | Lipid profile not perf | Description: Fasting lipid profile not performed, reason not given |
| G8730 | Pain doc pos and plan | Description: Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
| G8731 | Pain neg no plan | Description: Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
| G8732 | No doc of pain | Description: No documentation of pain assessment, reason not given |
| G8736 | Ldl-c <100mg/dl | Description: Most current ldl-c <100mg/dl |
| G8737 | Ldl-c >=100mg/dl | Description: Most current ldl-c >=100mg/dl |
| G8738 | Lvef < 40% | Description: Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function |
| G8739 | Lvef >= 40% | Description: Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function |
| G8740 | Lvef not perfrmd | Description: Left ventricular ejection fraction (lvef) not performed or assessed, reason not given |
| G8751 | Smkg status not assess | Description: Smoking status and exposure to second hand smoke in the home not assessed, reason not given |
| G8757 | Copd mg qual act perform | Description: All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient |
| G8758 | Ibd mg qual act perform | Description: All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient |
| G8759 | Osa mg qual act perform | Description: All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient |
| G8761 | Dementia mg qual act perform | Description: All quality actions for the applicable measures in the dementia measures group have been performed for this patient |
| G8762 | Pd mg qual act perform | Description: All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient |
| G8763 | Hyperten mg qual act perform | Description: All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient |