Medical Billing Code Search
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8890 results found
| G8767 | Lipid panel res doc rev | Description: Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c) |
| G8768 | Doc med reas no lipid profle | Description: Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8769 | Lipid profile not perform | Description: Lipid profile not performed, reason not given |
| G8770 | Urine protein test doc rev | Description: Urine protein test result documented and reviewed |
| G8771 | Doc dx ckd | Description: Documentation of diagnosis of chronic kidney disease |
| G8772 | Doc med reas no urine protn | Description: Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate) |
| G8773 | No urine protein test | Description: Urine protein test was not performed, reason not given |
| G8774 | Serum creatinine doc rev | Description: Serum creatinine test result documented and reviewed |
| G8775 | Doc med reas no serum crtn | Description: Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8776 | No serum creatinine test | Description: Serum creatinine test not performed, reason not given |
| G8777 | Diabetes screen | Description: Diabetes screening test performed |
| G8778 | Doc med reas no diabete scrn | Description: Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8779 | No diabetes screen | Description: Diabetes screening test not performed, reason not given |
| G8780 | Counsel diet phys activity | Description: Counseling for diet and physical activity performed |
| G8781 | Doc med reas no counsel diet | Description: Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8782 | No counsel diet phys act | Description: Counseling for diet and physical activity not performed, reason not given |
| G8784 | Pt no elig for bp assess | Description: Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation) |
| G8809 | Rh-immunoglobulin order | Description: Rh-immunoglobulin (rhogam) ordered |
| G8810 | Doc reas no rh-immuno | Description: Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal) |
| G8811 | No rh-immunoglobulin order | Description: Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given |
| G8818 | Pt disch to home by day#7 | Description: Patient discharge to home no later than post-operative day #7 |
| G8825 | Pt not disch to home day#7 | Description: Patient not discharged to home by post-operative day #7 |
| G8848 | Mild osa | Description: Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15) |
| G8852 | Pos air press prescribe | Description: Positive airway pressure therapy was prescribed |
| G8853 | Pos air press not prescribe | Description: Positive airway pressure therapy not prescribed |
| G8859 | Corticosteroids 10mg 60 days | Description: Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days |
| G8860 | Corticosteroid 10 mg 60 days | Description: Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days |
| G8861 | Dxa ordered for osteo | Description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed |
| G8862 | No corticostrd 10mg 60 days | Description: Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days |
| G8868 | 1st course antitnf | Description: Patients receiving a first course of anti-tnf therapy |
| G8870 | Hepb admin 1st antitnf | Description: Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy |
| G8871 | No 1st antitnf | Description: Patient not receiving a first course of anti-tnf therapy |
| G8872 | Intraop image confirm excise | Description: Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion |
| G8873 | Specimen not intraop image | Description: Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site) |
| G8874 | Tissue not image intraop | Description: Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion |
| G8879 | Node neg inv brst cncr | Description: Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer |
| G8883 | Rev, comm, track, doc biopsy | Description: Biopsy results reviewed, communicated, tracked and documented |
| G8884 | Doc reas biopsy not review | Description: Clinician documented reason that patient's biopsy results were not reviewed |
| G8885 | No rev, comm, track biopsy | Description: Biopsy results not reviewed, communicated, tracked or documented |
| G8886 | Bp under control | Description: Most recent blood pressure under control |
| G8887 | Doc med reas bp not control | Description: Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8888 | Bp not under control | Description: Most recent blood pressure not under control, results documented and reviewed |
| G8889 | No doc bp | Description: No documentation of blood pressure measurement, reason not given |
| G8890 | Ldl-c under control | Description: Most recent ldl-c under control, results documented and reviewed |
| G8891 | Doc med reas no ldl-c contrl | Description: Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8892 | Doc med reas no ldl-c test | Description: Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate) |
| G8893 | Ldl-c not under control | Description: Most recent ldl-c not under control, results documented and reviewed |
| G8894 | Ldl-c not performed | Description: Ldl-c not performed, reason not given |
| G8895 | Antrom prescribe | Description: Oral aspirin or other antithrombotic therapy prescribed |
| G8896 | Doc med reas no antihtrom | Description: Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled) |
| G8897 | Antithrom not prescribe | Description: Oral aspirin or other antithrombotic therapy was not prescribed, reason not given |
| G8898 | Copd measures group | Description: I intend to report the chronic obstructive pulmonary disease (copd) measures group |
| G8899 | Inflammatory bowel dis mg | Description: I intend to report the inflammatory bowel disease (ibd) measures group |
| G8900 | Obstructive sleep apnea mg | Description: I intend to report the sleep apnea measures group |
| G8902 | Dementia measures group | Description: I intend to report the dementia measures group |
| G8903 | Parkinson's disease mg | Description: I intend to report the parkinson's disease measures group |
| G8904 | Hypertension mg | Description: I intend to report the hypertension (htn) measures group |
| G8905 | Cardiovascular prevention mg | Description: I intend to report the cardiovascular prevention measures group |
| G8906 | Cataract measures group | Description: I intend to report the cataract measures group |
| G8925 | Spir fev1/fvc>=60% & no copd | Description: Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms |
| G8926 | Spiro no perf or doc | Description: Spirometry test not performed or documented, reason not given |
| G8927 | Adj chem pres ajcc iii | Description: Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer |
| G8928 | Adj chem not pres rsn spec | Description: Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons) |
| G8929 | Adj cmo not pres rsn not gvn | Description: Adjuvant chemotherapy not prescribed or previously received, reason not given |
| G8930 | Assess of dep @ initial eval | Description: Assessment of depression severity at the initial evaluation |
| G8931 | Asses of dep not documented | Description: Assessment of depression severity not documented, reason not given |
| G8932 | Suicd rsk assessed init eval | Description: Suicide risk assessed at the initial evaluation |
| G8933 | Suicide risk not assessed | Description: Suicide risk not assessed at the initial evaluation, reason not given |
| G8938 | Bmi doc onl fup nt doc | Description: Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
| G8939 | Pain as doc positive, no f/u | Description: Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter |
| G8940 | Scr dep pos, no plan done | Description: Screening for depression documented as positive, a follow-up plan not completed, documented reason |
| G8941 | Eld maltreatment doc as pos | Description: Elder 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 encounter |
| G8943 | Ldlc not pres w/i 12 mo prir | Description: Ldl-c result not present or not within 12 months prior |
| G8947 | 1 or more neuropsych | Description: One or more neuropsychiatric symptoms |
| G8948 | No neuropsych symptoms | Description: No neuropsychiatric symptoms |
| G8949 | Doc pt reas on counsel diet | Description: Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes) |
| G8951 | Pre-htn/htn doc, no pt f/u | Description: Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible |
| G8953 | Oncology mg qual act perform | Description: All quality actions for the applicable measures in the oncology measures group have been performed for this patient |
| G8957 | Pt no hedia in outpt fac | Description: Patient not receiving maintenance hemodialysis in an outpatient dialysis facility |
| G8959 | Clin tx mdd comm to tx clin | Description: Clinician treating major depressive disorder communicates to clinician treating comorbid condition |
| G8960 | Clin tx mdd not comm | Description: Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given |
| G8963 | Csi per asx pt w/pci 2 yrs | Description: Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years |
| G8964 | Csi any other than pci 2 yr | Description: Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc) |
| G8971 | Warfrn or othr antcog no rx | Description: Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given |
| G8972 | 1>=risk or>= mod risk for te | Description: One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism |
| G8973 | Mst rcnt hbb < 10g/dl | Description: Most recent hemoglobin (hgb) level < 10 g/dl |
| G8974 | Hgb not doc rns not gvn | Description: Hemoglobin level measurement not documented, reason not given |
| G8975 | Hgb <10g/dl, med rsn | Description: Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons) |
| G8976 | Hgb >= 10 g/dl | Description: Most recent hemoglobin (hgb) level >= 10 g/dl |
| G8977 | Oncology measures grp | Description: I intend to report the oncology measures group |
| G8978 | Mobility current status | Description: Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8979 | Mobility goal status | Description: Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8980 | Mobility d/c status | Description: Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8981 | Body pos current status | Description: Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8982 | Body pos goal status | Description: Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8983 | Body pos d/c status | Description: Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8984 | Carry current status | Description: Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8985 | Carry goal status | Description: Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8986 | Carry d/c status | Description: Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8987 | Self care current status | Description: Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8988 | Self care goal status | Description: Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8989 | Self care d/c status | Description: Self care functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8990 | Other pt/ot current status | Description: Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8991 | Other pt/ot goal status | Description: Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8992 | Other pt/ot d/c status | Description: Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8993 | Sub pt/ot current status | Description: Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals |
| G8994 | Sub pt/ot goal status | Description: Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8995 | Sub pt/ot d/c status | Description: Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8996 | Swallow current status | Description: Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
| G8997 | Swallow goal status | Description: Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G8998 | Swallow d/c status | Description: Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting |
| G8999 | Motor speech current status | Description: Motor speech functional limitation, current status at therapy episode outset and at reporting intervals |
| G9017 | Amantadine hcl 100mg oral | Description: Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project) |
| G9018 | Zanamivir,inhalation pwd 10m | Description: Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project) |
| G9019 | Oseltamivir phosphate 75mg | Description: Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project) |
| G9020 | Rimantadine hcl 100mg oral | Description: Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project) |
| G9033 | Amantadine hcl oral brand | Description: Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project) |
| G9034 | Zanamivir, inh pwdr, brand | Description: Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project) |
| G9035 | Oseltamivir phosp, brand | Description: Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project) |
| G9036 | Rimantadine hcl, brand | Description: Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project) |
| G9158 | Motor speech d/c status | Description: Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting |
| G9159 | Lang comp current status | Description: Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals |
| G9160 | Lang comp goal status | Description: Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9161 | Lang comp d/c status | Description: Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting |
| G9162 | Lang express current status | Description: Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals |
| G9163 | Lang express goal status | Description: Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9164 | Lang express d/c status | Description: Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting |
| G9165 | Atten current status | Description: Attention functional limitation, current status at therapy episode outset and at reporting intervals |
| G9166 | Atten goal status | Description: Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9167 | Atten d/c status | Description: Attention functional limitation, discharge status at discharge from therapy or to end reporting |
| G9168 | Memory current status | Description: Memory functional limitation, current status at therapy episode outset and at reporting intervals |
| G9169 | Memory goal status | Description: Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9170 | Memory d/c status | Description: Memory functional limitation, discharge status at discharge from therapy or to end reporting |
| G9171 | Voice current status | Description: Voice functional limitation, current status at therapy episode outset and at reporting intervals |
| G9172 | Voice goal status | Description: Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9173 | Voice d/c status | Description: Voice functional limitation, discharge status at discharge from therapy or to end reporting |
| G9174 | Speech lang current status | Description: Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals |
| G9175 | Speech lang goal status | Description: Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9176 | Speech lang d/c status | Description: Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting |
| G9186 | Motor speech goal status | Description: Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
| G9192 | System reason for no beta | Description: Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system) |
| G9193 | Doc not eligible for dep med | Description: Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression |
| G9194 | Mdd pt treated for 180d | Description: Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase |
| G9195 | Mdd pt not treated for 180d | Description: Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase |
| G9196 | Med reason for no ceph | Description: Documentation 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, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s)) |
| G9197 | Order for ceph | Description: Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis |
| G9198 | No order for ceph no reason | Description: Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given |
| G9199 | Doc reason for no vte | Description: Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s)) |
| G9200 | No reason for no vte | Description: Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given |
| G9201 | Vte given upon admission | Description: Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission |
| G9202 | Hep c aby pos | Description: Patients with a positive hepatitis c antibody test |
| G9203 | Hep c rna done prior to med | Description: Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c |
| G9204 | No reason for no hep c rna | Description: Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given |
| G9205 | Hep c antiviral started | Description: Patient starting antiviral treatmentfor hepatitis c during the measurement period |
| G9206 | Hep c therapy started | Description: Patient starting antiviral treatment for hepatitis c during the measurement period |
| G9207 | Hep c genotype prior to med | Description: Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c |
| G9208 | No reason for no hep c geno | Description: Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given |
| G9209 | Hep c rna 4to12 wk after med | Description: Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment |
| G9210 | No hepc rna after med docrsn | Description: Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons) |
| G9211 | No hepc rna after med no rsn | Description: Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given |
| G9214 | Cd4 count documented | Description: Cd4+ cell count or cd4+ cell percentage results documented |
| G9215 | No cd4 count no reason | Description: Cd4+ cell count or percentage not documented as performed, reason not given |
| G9216 | No pcp proph at dx no reason | Description: Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given |
| G9217 | No pcp proph low cd4 norsn | Description: Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given |
| G9218 | No pcp prop low at cd4 norsn | Description: Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given |
| G9219 | No oder pjp for med reason | Description: Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
| G9220 | No order for pjp for medrsn | Description: Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
| G9221 | Pjp proph prescribed | Description: Pneumocystis jiroveci pneumonia prophlaxis prescribed |
| G9222 | Pjp proph ordered low cd4 | Description: Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3 |
| G9224 | Medrsn no foot exam | Description: Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation) |
| G9229 | Ptrsn no gc chl syp test | Description: Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception) |
| G9232 | Ptrsn no comm comorbid | Description: Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason) |
| G9233 | Tkr composite | Description: All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient |
| G9234 | Tkr intent | Description: I intend to report the total knee replacement measures group |
| G9235 | Gs mg composite | Description: All quality actions for the applicable measures in the general surgery measures group have been performed for this patient |
| G9236 | Op rad mg composite | Description: All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient |
| G9237 | Gs mg intent | Description: I intend to report the general surgery measures group |
| G9238 | Op rad mg intent | Description: I intend to report the optimizing patient exposure to ionizing radiation measures group |
| G9239 | Doc rsn hemod & cath acc | Description: Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons) |
| G9240 | Doc pt w cath maint dia | Description: Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated |
| G9241 | Doc pt w out cath maint dia | Description: Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated |
| G9244 | Antiviral not ordered | Description: Antiretroviral thereapy not prescribed |
| G9245 | Antiviral ordered | Description: Antiretroviral therapy prescribed |
| G9248 | No med visit 6mo | Description: Patient did not have a medical visit in the last 6 months |
| G9249 | Med visit w in 6mo | Description: Patient had a medical visit in the last 6 months |
| G9250 | Doc of pain comfort 48hr | Description: Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment |
| G9251 | Doc no pain comfort 48hr | Description: Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment |
| G9252 | Neo detect scrn colo | Description: Adenoma(s) or other neoplasm detected during screening colonoscopy |
| G9253 | No neo detect scrn colo | Description: Adenoma(s) or other neoplasm not detected during screening colonoscopy |
| G9256 | Doc of pat death after cas | Description: Documentation of patient death following cas |
| G9257 | Doc of pat stroke after cas | Description: Documentation of patient stroke following cas |
| G9258 | Doc of pat stroke after cea | Description: Documentation of patient stroke following cea |
| G9259 | Survive/no stroke post cas | Description: Documentation of patient survival and absence of stroke following cas |
| G9260 | Doc of pat death after cea | Description: Documentation of patient death following cea |
| G9261 | Survive/no stroke post cea | Description: Documentation of patient survival and absence of stroke following cea |
| G9262 | Doc of death post-aaa repair | Description: Documentation of patient death in the hospital following endovascular aaa repair |
| G9263 | Doc of disch post-aaa repair | Description: Documentation of patient discharged alive following endovascular aaa repair |
| G9264 | Doc rsn hemod w/cath >=90d | Description: Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons) |
| G9265 | Doc cath >90d for maint dia | Description: Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access |
| G9266 | Norsn pt cath >=90d | Description: Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access |
| G9267 | Doc comp or mort w in 30d | Description: Documentation of patient with one or more complications or mortality within 30 days |
| G9268 | Doc comp or mort w in 90d | Description: Documentation of patient with one or more complications within 90 days |
| G9269 | Doc no comp or mort w in 30d | Description: Documentation of patient without one or more complications and without mortality within 30 days |
| G9270 | Doc no comp or mort w in 90d | Description: Documentation of patient without one or more complications within 90 days |
| G9271 | Ldl under 100 | Description: Ldl value < 100 |
| G9272 | Ldl 100 and over | Description: Ldl value >= 100 |
| G9300 | Doc medrsn no compl antibio | Description: Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used) |
| G9301 | Doc compl inf antibio | Description: Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet |
| G9302 | Norsn incomp inf antibio | Description: Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given |
| G9303 | Norsn no pros info op rpt | Description: Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given |
| G9304 | Pros info op rpt | Description: Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant |
| G9320 | Medrsn no std nomenclature | Description: Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9323 | Mdrsn no doc cnt of ct | Description: Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9324 | Not all data norsn | Description: All necessary data elements not included, reason not given |
| G9325 | Medrsn no ct rpt to reg | Description: Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9326 | Ct done no rad ds index, nrg | Description: Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given |
| G9327 | Ct done rad ds index | Description: Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements |
| G9328 | Medrsn no dicom format doc | Description: Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9329 | Norsn no dicom format doc | Description: 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 study not documented in final report, reason not given |
| G9340 | Dicom format doc on rpt | Description: Final 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 study |
| G9343 | Medrsn no dicom srch | Description: Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9346 | No follow up pulm nod | Description: Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9348 | Doc rsn for ord ct scan | Description: Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons |
| G9349 | Ct within 28 days | Description: Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis |
| G9350 | No doc sinus ct 28d or dx | Description: Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis |
| G9359 | Neg mgd pos tb notact | Description: Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier |
| G9360 | No doc of neg or man pos tb | Description: No documentation of negative or managed positive tb screen |
| G9362 | Mac or pnb w/o genanes >60m | Description: Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record |
| G9363 | Mac or pnb w/o genanes <60m | Description: Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record |
| G9365 | 1high risk med ord | Description: One high-risk medication ordered |
| G9366 | 1high risk no ord | Description: One high-risk medication not ordered |
| G9369 | Fill 2 rx antipsych | Description: Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater |
| G9370 | Not fill 2 rx antipsych | Description: Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater |
| G9376 | Contd ret attach at 6mth f/u | Description: Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery |
| G9377 | No ret attach after 6mt | Description: Patient did not have the retina attached after 6 months following only one surgery |
| G9378 | Contd ret attach f/u vis | Description: Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) |
| G9379 | No acheive flat ret 6mth | Description: Patient did not achieve flat retinas six months post surgery |
| G9381 | Doc med reas no offer eol | Description: Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period |
| G9389 | Unpln rup post cap | Description: Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery |
| G9390 | No unpln rup post cap | Description: No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery |
| G9391 | Achv refrac +1d | Description: Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit |
| G9392 | Not achv refrac +1d | Description: Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit |
| G9399 | Doc disc tx choices | Description: Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment |
| G9400 | Doc reas no disc tx opt | Description: Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons |
| G9401 | No disc tx choices | Description: No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment |
| G9433 | Death, nhres, hospice | Description: Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period |
| G9435 | Asp presc disch | Description: Aspirin prescribed at discharge |
| G9436 | Asp not presc doc reas | Description: Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed) |
| G9437 | Asp not presc disch | Description: Aspirin not prescribed at discharge |
| G9438 | P2y inhib presc | Description: P2y inhibitor prescribed at discharge |
| G9439 | P2y inhib not presc doc reas | Description: P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed) |
| G9440 | P2y inhib not presc | Description: P2y inhibitor not prescribed at discharge |
| G9441 | Statin presc disch | Description: Statin prescribed at discharge |
| G9442 | Statin not presc doc reas | Description: Statin not prescribed for documented reasons (e.g., allergy, medical intolerance) |
| G9443 | Statin not presc disch | Description: Statin not prescribed at discharge |
| G9448 | Born 1945-1965 | Description: Patients who were born in the years 1945 to 1965 |
| G9449 | Hx bld transf b/f 1992 | Description: History of receiving blood transfusions prior to 1992 |
| G9450 | Hx injec drug use | Description: History of injection drug use |
| G9451 | 1x scrn hcv infect | Description: Patient received one-time screening for hcv infection |
| G9453 | Pt reas no hcv infect | Description: Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons) |
| G9454 | No scr hcv inf 12 mth rp | Description: One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given |
| G9463 | Sinusitis intent | Description: I intend to report the sinusitis measures group |
| G9464 | Sinusitis comp | Description: All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient |
| G9465 | Aoe intent | Description: I intend to report the acute otitis externa (aoe) measures group |
| G9466 | Aoe comp | Description: All quality actions for the applicable measures in the aoe measures group have been performed for this patient |
| G9467 | Recd cortico >=10mg/day >60d | Description: Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months |
| G9469 | Rec cortico>90d or 1rx 900mg | Description: Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills |
| G9472 | No dxa no med hx no rv sx | Description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed |
| G9496 | Doc rsn no adeno/neopl detec | Description: Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma |
| G9499 | No start/rec antvir tx hep c | Description: Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period |
| G9503 | Pt tk tams hcl | Description: Patient taking tamsulosin hydrochloride |
| G9506 | Bio imm resp mod presc | Description: Biologic immune response modifier prescribed |
| G9523 | D/c hemo or perit dialysis | Description: Patient discontinued from hemodialysis or peritoneal dialysis |
| G9524 | Refer to hospice | Description: Patient was referred to hospice care |
| G9525 | Doc pt reas no hospice refer | Description: Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons) |
| G9526 | No reason, no refer hospice | Description: Patient was not referred to hospice care, reason not given |
| G9532 | Pt hd ct ord | Description: Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma |
| G9534 | Adv brain image not ordered | Description: Advanced brain imaging (cta, ct, mra or mri) was not ordered |
| G9535 | Normal neuro exam | Description: Patients with a normal neurological examination |
| G9536 | Doc med reas adv brain image | Description: Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms) |
| G9538 | Adv brain image ordered | Description: Advanced brain imaging (cta, ct, mra or mri) was ordered |
| G9558 | Tx beta-lactam abx therapy | Description: Patient treated with a beta-lactam antibiotic as definitive therapy |
| G9559 | Doc med reas no abx therapy | Description: Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics) |
| G9560 | No beta-lactam abx ther, rng | Description: Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given |
| G9561 | Presc opiates >6 wks | Description: Patients prescribed opiates for longer than six weeks |
| G9562 | Foll-up eval q3mo opiod tx | Description: Patients who had a follow-up evaluation conducted at least every three months during opioid therapy |
| G9563 | No f/u eval q3mo opiod tx | Description: Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy |
| G9572 | Phq-scr >9 doc in 12m time | Description: Index date phq-score greater than 9 documented during the twelve month denominator identification period |
| G9573 | Adl pt md or dys rem 6 mon | Description: Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five |
| G9574 | Adl pt md dys no rem 6 mon | Description: Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five |
| G9577 | Presc opiates >6 wks | Description: Patients prescribed opiates for longer than six weeks |
| G9578 | Doc opioid tx 1x during ther | Description: Documentation of signed opioid treatment agreement at least once during opioid therapy |
| G9579 | No doc opioid tx 1x at ther | Description: No documentation of signed an opioid treatment agreement at least once during opioid therapy |
| G9581 | Md doc, door to punc tm >2hr | Description: Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment) |
| G9583 | Presc opiates >6 wks | Description: Patients prescribed opiates for longer than six weeks |
| G9584 | Eval opioid use instr/pt int | Description: Patient 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 therapy |
| G9585 | No eval opi use instr/intv | Description: Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy |
| G9596 | Ped pt hd ct ord | Description: Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma |
| G9600 | Symp aaa urgent repair | Description: Symptomatic aaas that required urgent/emergent (non-elective) repair |
| G9601 | Pt dchg home post op day 7 | Description: Patient discharge to home no later than post-operative day #7 |
| G9602 | Pt no dchg home postop day 7 | Description: Patient not discharged to home by post-operative day #7 |
| G9612 | Phodoc 2 mr cec lndmk | Description: Photodocumentation of two or more cecal landmarks to establish a complete examination |
| G9613 | Doc post surg anatomy | Description: Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.) |
| G9614 | Photodoc < 2 cec lndmk | Description: Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination |
| G9615 | Pre-op asst doc | Description: Preoperative assessment documented |
| G9616 | Doc rsn no preop assmt | Description: Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery) |
| G9617 | Pre-op asst not doc, rng | Description: Preoperative assessment not documented, reason not given |
| G9618 | Doc scr uter mal or us/samp | Description: Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind |
| G9619 | Doc rsn no scr uter malig | Description: Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy) |
| G9620 | No scr utr malig/us/samp rng | Description: Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given |
| G9623 | Doc med rsn no scr etoh use | Description: Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons) |
| G9631 | Pt ui srg 30 day pst srg | Description: Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery |
| G9632 | Med rsn for no rpt uret inj | Description: Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury) |
| G9633 | Pt no ui srg 30 day pst srg | Description: Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery |
| G9634 | Qual life tool 2x same/impr | Description: Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved |
| G9635 | No doc rsn do qual life assm | Description: Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire) |
| G9636 | No life asst 2x same/decr | Description: Health-related quality of life not assessed with tool during at least two visits or quality of life score declined |
| G9639 | Amp no reqd in48h ieler proc | Description: Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure |
| G9640 | Doc plan hybrid/stage proc | Description: Documentation of planned hybrid or staged procedure |
| G9641 | Amp reqd w/in 48h ieler proc | Description: Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure |
| G9647 | No mrs score in 90d followup | Description: Patients in whom mrs score could not be obtained at 90 day follow-up |
| G9650 | Doc pt no ther chg or contra | Description: Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi |
| G9652 | Pt tx sys bio med psori 6mth | Description: Patient has been treated with a systemic or biologic medication for psoriasis for at least six months |
| G9653 | Pt no tx sys bio rx 6 mths | Description: Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months |
| G9657 | Toc dur aneth to icu | Description: Transfer of care during an anesthetic or to the intensive care unit |
| G9666 | Fas/dir ldl 70-189mg/dl mst | Description: Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl |
| G9667 | Doc med rsn no stat tx/presc | Description: Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy) |
| G9669 | Intend rpt mult chr msr grp | Description: I intend to report the multiple chronic conditions measures group |
| G9670 | Qty act mcc mg perf | Description: All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient |
| G9671 | Intend rpt dia retin msr grp | Description: I intend to report the diabetic retinopathy measures group |
| G9672 | Qty act diab retin mg perf | Description: All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient |
| G9673 | Intend rpt card prev msr grp | Description: I intend to report the cardiovascular prevention measures group |
| G9677 | Qty act card prev mg perf | Description: All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient |
| G9678 | Oncology care model service | Description: Oncology 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 participation agreement |
| G9686 | Nursing facility conference | Description: Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team |
| G9697 | Pt rsn no presc bronchdil | Description: Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator |
| G9701 | Child anbx 30 prior dx estab | Description: Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established |
| G9715 | Pt w/hosp anytime msmt per | Description: Patients who use hospice services any time during the measurement period |
| G9718 | Hospice anytime msmt per | Description: Hospice services for patient provided any time during the measurement period |
| G9725 | Pt w/hosp anytime msmt per | Description: Patients who use hospice services any time during the measurement period |
| G9738 | Refused to participate | Description: Patient refused to participate |
| G9739 | Pt unbl cmplt go fs prom | Description: Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available |
| G9742 | Psych sympt assessed | Description: Psychiatric symptoms assessed |
| G9743 | Psych symp not assessed, rns | Description: Psychiatric symptoms not assessed, reason not otherwise specified |
| G9747 | Pall dialysis with catheter | Description: Patient is undergoing palliative dialysis with a catheter |
| G9748 | App transpl lvg kidney donor | Description: Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant |
| G9749 | Pall dialysis with catheter | Description: Patient is undergoing palliative dialysis with a catheter |
| G9750 | App transpl lvg kidney donor | Description: Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant |
| G9759 | Hx preop post cap rup | Description: History of preoperative posterior capsule rupture |
| G9774 | Pt had hyst | Description: Patients who have had a hysterectomy |
| G9778 | Pts dx w/pregn | Description: Patients who have a diagnosis of pregnancy at any time during the measurement period |
| G9783 | Doc dx dm, fast <70, no stat | Description: Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy |
| G9798 | D/c ami btw 7/1-6/30 meas pd | Description: Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period |
| G9799 | Med disp evt indic hx asth | Description: Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period |
| G9800 | Pt id intol/alleg beta-block | Description: Patients who are identified as having an intolerance or allergy to beta-blocker therapy |
| G9801 | Nonacut transf from inpt | Description: Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis |
| G9802 | Pt w/hosp anytime msmt per | Description: Patients who use hospice services any time during the measurement period |
| G9803 | Pt presc 135 day trmt | Description: Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami |
| G9804 | Pt not presc 135 day trmt | Description: Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami |
| G9808 | Pt no asthm cont med mst per | Description: Any patients who had no asthma controller medications dispensed during the measurement year |
| G9809 | Pt w/hosp anytime msmt per | Description: Patients who use hospice services any time during the measurement period |
| G9810 | Pdc 75% w/asth cont med | Description: Patient achieved a pdc of at least 75% for their asthma controller medication |
| G9811 | No pdc 75% w/asth cont med | Description: Patient did not achieve a pdc of at least 75% for their asthma controller medication |
| G9814 | Death during index hosp | Description: Death occurring during the index acute care hospitalization |
| G9815 | Death not during index hosp | Description: Death did not occur during the index acute care hospitalization |
| G9816 | Death <30 day post discharge | Description: Death occurring after discharge from the hospital but within 30 days post procedure |
| G9817 | No death 30-days post-disch | Description: Death did not occur after discharge from the hospital within 30 days post procedure |
| G9825 | Her-2 neg,undoc/unkn | Description: Her-2/neu negative or undocumented/unknown |
| G9826 | Transf pract aft init chemo | Description: Patient transferred to practice after initiation of chemotherapy |
| G9827 | Her-2 targ ther no init tx | Description: Her2-targeted therapies not administered during the initial course of treatment |
| G9828 | Her-2 targ ther dur init tx | Description: Her2-targeted therapies administered during the initial course of treatment |
| G9829 | Breast adj chemo admin | Description: Breast adjuvant chemotherapy administered |
| G9833 | Transf pract aft init chemo | Description: Patient transfer to practice after initiation of chemotherapy |
| G9834 | Pt met dis at dx | Description: Patient has metastatic disease at diagnosis |
| G9835 | Trastuz given w/in 12 mos dx | Description: Trastuzumab administered within 12 months of diagnosis |
| G9836 | Rsn no trast given doc | Description: Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete) |
| G9837 | Trastuz not in 12 mos dx | Description: Trastuzumab not administered within 12 months of diagnosis |
| G9849 | Pt died from cancer | Description: Patients who died from cancer |
| G9850 | 1/more ed last 30d life | Description: Patient had more than one emergency department visit in the last 30 days of life |
| G9851 | 1/no ed visit last 30d life | Description: Patient had one or less emergency department visits in the last 30 days of life |
| G9852 | Pt died from cancer | Description: Patients who died from cancer |
| G9853 | Icu stay last 30d life | Description: Patient admitted to the icu in the last 30 days of life |
| G9854 | No icu stay last 30d life | Description: Patient was not admitted to the icu in the last 30 days of life |
| G9855 | Pt died from cancer | Description: Patients who died from cancer |
| G9856 | Pt no hospice | Description: Patient was not admitted to hospice |
| G9857 | Pt admit hospice | Description: Patient admitted to hospice |
| G9904 | Doc med rsn no tbco scrn | Description: Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason) |
| G9907 | Doc med rsn no tbco interv | Description: Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months (e.g., limited life expectancy, other medical reason) |
| G9909 | Doc med rsn no tbco interv | Description: Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason) |
| G9924 | Doc med rsn no scrn or recs | Description: Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason) |
| G9927 | Doc no warf /fda pt trial | Description: Documentation of system reason(s) for not prescribing an fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment |
| G9932 | Doc pt rsn no tb scrn recrds | Description: Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation) |
| G9933 | Canc detectd during col scrn | Description: Adenoma(s) or colorectal cancer detected during screening colonoscopy |
| G9934 | Doc rsn not detecting cancer | Description: Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma |
| G9935 | Canc not detectd during srcn | Description: Adenoma(s) or colorectal cancer not detected during screening colonoscopy |
| G9936 | Pmh plyp/neo co/rect/jun/ans | Description: Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus |
| G9937 | Dig or surv colsco | Description: Diagnostic colonoscopy |
| G9941 | Pre and post vas wthn 3 mos | Description: Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively |
| G9942 | Adtl spine proc on same date | Description: Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy |
| G9944 | Vas 3 mon pre and 1 yr post | Description: Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively |
| G9947 | Pre and post vas wthn 3 mos | Description: Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively |
| G9948 | Adtl spine proc on same date | Description: Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy |
| G9966 | Scrn, inter, report child | Description: Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report |
| G9967 | No scrn, inter, reprt child | Description: Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report |
| G9989 | Med rsn no pneum vax | Description: Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., adverse reaction to vaccine) |
| G9995 | Pall serv during meas | Description: Patients who use palliative care services any time during the measurement period |
| J0150 | Injection adenosine 6 mg | Description: Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270) |
| J0151 | Inj adenosine diag 1mg | Description: Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270) |
| J0610 | Calcium glucon (fresenius) | Description: Injection, calcium gluconate (fresenius kabi), per 10 ml |
| J0611 | Calcium glucon (wg critical) | Description: Injection, calcium gluconate (wg critical care), per 10 ml |
| J0693 | Inj., cefiderocol, 5 mg | Description: Injection, cefiderocol, 5 mg |
| J0760 | Colchicine injection | Description: Injection, colchicine, per 1 mg |
| J0800 | Corticotropin injection | Description: Injection, corticotropin, up to 40 units |
| J0833 | Cosyntropin injection nos | Description: Injection, cosyntropin, not otherwise specified, 0.25 mg |
| J0886 | Epoetin alfa 1000 units esrd | Description: Injection, epoetin alfa, 1000 units (for esrd on dialysis) |
| J0900 | Testosterone enanthate inj | Description: Injection, testosterone enanthate and estradiol valerate, up to 1 cc |
| J1060 | Testosterone cypionate 1 ml | Description: Injection, testosterone cypionate and estradiol cypionate, up to 1 ml |
| J1070 | Testosterone cypionat 100 mg | Description: Injection, testosterone cypionate, up to 100 mg |
| J1080 | Testosterone cypionat 200 mg | Description: Injection, testosterone cypionate, 1 cc, 200 mg |
| J1446 | Inj, tbo-filgrastim, 5 mcg | Description: Injection, tbo-filgrastim, 5 micrograms |
| J1590 | Gatifloxacin injection | Description: Injection, gatifloxacin, 10 mg |
| J1725 | Hydroxyprogesterone caproate | Description: Injection, hydroxyprogesterone caproate, 1 mg |
| J1942 | Aripiprazole lauroxil 1mg | Description: Injection, aripiprazole lauroxil, 1 mg |
| J2271 | Morphine so4 injection 100mg | Description: Injection, morphine sulfate, 100mg |
| J2275 | Morphine sulfate injection | Description: Injection, morphine sulfate (preservative-free sterile solution), per 10 mg |
| J2370 | Phenylephrine hcl injection | Description: Injection, phenylephrine hcl, up to 1 ml |
| J2400 | Chloroprocaine hcl injection | Description: Injection, chloroprocaine hydrochloride, per 30 ml |
| J2505 | Injection, pegfilgrastim 6mg | Description: Injection, pegfilgrastim, 6 mg |
| J3120 | Testosterone enanthate inj | Description: Injection, testosterone enanthate, up to 100 mg |
| J3130 | Testosterone enanthate inj | Description: Injection, testosterone enanthate, up to 200 mg |
| J3140 | Testosterone suspension inj | Description: Injection, testosterone suspension, up to 50 mg |
| J3150 | Testosteron propionate inj | Description: Injection, testosterone propionate, up to 100 mg |
| J7302 | Levonorgestrel iu 52 mg | Description: Levonorgestrel-releasing intrauterine contraceptive system, 52 mg |
| J7303 | Contraceptive vaginal ring | Description: Contraceptive supply, hormone containing vaginal ring, each |
| J7333 | Visco-3 inj dose | Description: Hyaluronan or derivative, visco-3, for intra-articular injection, per dose |
| J7335 | Capsaicin 8% patch | Description: Capsaicin 8% patch, per 10 square centimeters |
| J7401 | Mometasone furoate sinus imp | Description: Mometasone furoate sinus implant, 10 micrograms |
| J7506 | Prednisone oral | Description: Prednisone, oral, per 5 mg |
| J9010 | Alemtuzumab injection | Description: Injection, alemtuzumab, 10 mg |
| J9031 | Bcg live intravesical vac | Description: Bcg (intravesical) per instillation |
| J9044 | Inj, bortezomib, nos, 0.1 mg | Description: Injection, bortezomib, not otherwise specified, 0.1 mg |
| J9160 | Denileukin diftitox inj | Description: Injection, denileukin diftitox, 300 micrograms |
| J9199 | Injection, infugem, 200 mg | Description: Injection, gemcitabine hydrochloride (infugem), 200 mg |
| J9265 | Paclitaxel injection | Description: Injection, paclitaxel, 30 mg |
| J9300 | Gemtuzumab ozogamicin inj | Description: Injection, gemtuzumab ozogamicin, 5 mg |
| J9310 | Rituximab injection | Description: Injection, rituximab, 100 mg |
| J9315 | Romidepsin injection | Description: Injection, romidepsin, 1 mg |
| K0553 | Ther cgm supply allowance | Description: Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
| K0554 | Ther cgm receiver/monitor | Description: Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
| K0901 | Ko single upright pre ots | Description: Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
| K0902 | Ko double upright pre ots | Description: Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
| K0903 | Mult den insert dir carv/cam | Description: For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
| K1001 | Electronic posa treatment | Description: Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type |
| K1002 | Ces system | Description: Cranial electrotherapy stimulation (ces) system, any type |
| K1003 | Whirlpool tub walkin portabl | Description: Whirlpool tub, walk-in, portable |
| K1005 | Disp col sto bag breast milk | Description: Disposable collection and storage bag for breast milk, any size, any type, each |
| K1006 | Suct pum ext urine mgmt sys | Description: Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system |
| K1009 | Speech volume modulation sys | Description: Speech volume modulation system, any type, including all components and accessories |
| K1010 | Intraurethral drainag device | Description: Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each |
| K1011 | Acti intraurethral drainage | Description: Activation device for intraurethral drainage device with valve, replacement only, each |
| K1012 | Charger base station intraur | Description: Charger and base station for intraurethral activation device, replacement only |
| K1013 | Enema tube any type repl | Description: Enema tube, with or without adapter, any type, replacement only, each |
| K1014 | Ak 4 bar link hydl swg/stanc | Description: Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control |
| K1015 | Foot, adductus position, adj | Description: Foot, adductus positioning device, adjustable |
| K1016 | Trans elec nerv for trigemin | Description: Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve |
| K1017 | Monthly supp use with k1016 | Description: Monthly supplies for use of device coded at k1016 |
| K1018 | Ext up limb tremor stim wris | Description: External upper limb tremor stimulator of the peripheral nerves of the wrist |
| K1019 | Supp ext up limb tremor stim | Description: Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist |
| K1020 | Non-invasive vagus nerv stim | Description: Non-invasive vagus nerve stimulator |
| K1021 | Exsuff belt incl all sup acc | Description: Exsufflation belt, includes all supplies and accessories |
| K1022 | Endoskel posit rotat unit | Description: Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type |
| K1023 | Trans elec nerv periph nerv | Description: Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm |
| K1024 | Non pneum comp control cal | Description: Non-pneumatic compression controller with sequential calibrated gradient pressure |
| K1025 | Non pneum compress full arm | Description: Non-pneumatic sequential compression garment, full arm |
| K1026 | Mech allergen parti barrier | Description: Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical |
| K1028 | Control unit nm stim w phone | Description: Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application |
| K1029 | Oral dv/app neuromus mouthpi | Description: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply |
| K1031 | Non pneu comp control w/o ca | Description: Non-pneumatic compression controller without calibrated gradient pressure |
| K1032 | Non pneum seq comp full leg | Description: Non-pneumatic sequential compression garment, full leg |
| K1033 | Non pneum seq comp half leg | Description: Non-pneumatic sequential compression garment, half leg |
| L6025 | Part hand disart myoelectric | Description: Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device |
| L7260 | Electron wrist rotator otto | Description: Electronic wrist rotator, otto bock or equal |
| L7261 | Electron wrist rotator utah | Description: Electronic wrist rotator, for utah arm |
| M0064 | Visit for drug monitoring | Description: Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders |
| M0239 | Bamlanivimab-xxxx infusion | Description: Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
| M1000 | Pain scr as mod to sevr | Description: Pain screened as moderate to severe |
| M1001 | Pln to adrs pain doc | Description: Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician |
| M1002 | Pln to adrs pain not doc | Description: Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given |
| M1015 | Dc eoc doc med rec | Description: Discharge/discontinuation of the episode of care documented in the medical record |
| M1017 | Pt admt to palitve serv | Description: Patient admitted to palliative care services |
| M1022 | Pt hospice during perf pd | Description: Patients who were in hospice at any time during the performance period |
| M1023 | Adl pt mj dep ds rs 6 phq<5 | Description: Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five |
| M1024 | Adl pt mj dep ds no rs 6 mo | Description: Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five |
| M1025 | Pt hospice during perf pd | Description: Patients who were in hospice at any time during the performance period |
| M1026 | Pt hospice during perf pd | Description: Patients who were in hospice at any time during the performance period |
| M1030 | Pt clin ind img hd | Description: Patients with clinical indications for imaging of the head |
| M1031 | Pt clin ind img hd | Description: Patients with no clinical indications for imaging of the head |
| M1033 | Pharmthry for oud afr 6.30 | Description: Pharmacotherapy for oud initiated after june 30th of performance period |
| M1042 | Ftl st mea sco ot odi 3 mo | Description: Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively |
| M1044 | Ftl st mea odi 3 mo | Description: Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively |