Medical Billing Code Search
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9172 results found
| G0915 | No improve visual funct | Description: Improvement in visual function not achieved within 90 days following cataract surgery |
| G0916 | Satisfy with care | Description: Satisfaction with care achieved within 90 days following cataract surgery |
| G0917 | Care survey not complete | Description: Patient care survey was not completed by patient |
| G0918 | No satisfy with care | Description: Satisfaction with care not achieved within 90 days following cataract surgery |
| 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 |
| G1001 | Cdsm evicore | Description: Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program |
| G1002 | Cdsm medcurrent | Description: Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program |
| G1003 | Cdsm medicalis | Description: Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program |
| G1004 | Cdsm ndsc | Description: Clinical decision support mechanism national decision support company, 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 |
| G1007 | Cdsm aim | Description: Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program |
| G1008 | Cdsm cranberry pk | Description: Clinical decision support mechanism cranberry peak, 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 |
| G1010 | Cdsm stanson | Description: Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
| G1011 | Cdsm qualified nos | Description: Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program |
| G1012 | Cdsm agilemd | Description: Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria program |
| G1013 | Cdsm evidencecare | Description: Clinical decision support mechanism evidencecare imagingcare, as defined by the medicare appropriate use criteria program |
| G1014 | Cdsm inveniqa | Description: Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria program |
| G1015 | Cdsm reliant | Description: Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria program |
| G1016 | Cdsm speed of care | Description: Clinical decision support mechanism speed of care, as defined by the medicare appropriate use criteria program |
| G1017 | Cdsm healthhelp | Description: Clinical decision support mechanism healthhelp, as defined by the medicare appropriate use criteria program |
| G1018 | Cdsm infinx | Description: Clinical decision support mechanism infinx, as defined by the medicare appropriate use criteria program |
| G1019 | Cdsm logicnets | Description: Clinical decision support mechanism logicnets, as defined by the medicare appropriate use criteria program |
| G1020 | Cdsm curbside | Description: Clinical decision support mechanism curbside clinical augmented workflow, as defined by the medicare appropriate use criteria program |
| G1021 | Cdsm ehealthline | Description: Clinical decision support mechanism ehealthline clinical decision support mechanism, as defined by the medicare appropriate use criteria program |
| G1022 | Cdsm intermountain | Description: Clinical decision support mechanism intermountain clinical decision support mechanism, as defined by the medicare appropriate use criteria program |
| G1023 | Cdsm persivia | Description: Clinical decision support mechanism persivia clinical decision support, as defined by the medicare appropriate use criteria program |
| G1024 | Cdsm radrite | Description: Clinical decision support mechanism radrite, as defined by the medicare appropriate use criteria program |
| G1025 | Pt mnth 1 mcp prov | Description: Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month |
| G1026 | Pt hemo > 3mo | Description: The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month |
| G1027 | Pt hemo < 3mo | Description: The number of adult patient-months in the denominator who were on maintenance hemodialysis under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month using a catheter continuously for less than three months |
| G1028 | Take home supply 8mg per 0.1 | Description: Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2000 | Blinded conv. tx mdd clin tr | Description: Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session |
| G2001 | Post d/c h vst new pt 20 m | Description: Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2002 | Post-d/c h vst new pt 30 m | Description: Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2003 | Post-d/c h vst new pt 45 m | Description: Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2004 | Post-d/c h vst new pt 60 m | Description: Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2005 | Post-d/c h vst new pt 75 m | Description: Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2006 | Post-d/c h vst ext pt 20 m | Description: Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2007 | Post-d/c h vst ext pt 30 m | Description: Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2008 | Post-d/c h vst ext pt 45 m | Description: Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2009 | Post-d/c h vst ext pt 60 m | Description: Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2010 | Remot image submit by pt | Description: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment |
| G2011 | Alcohol/sub misuse assess | Description: Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes |
| G2012 | Brief check in by md/qhp | Description: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
| G2013 | Post-d/c h vst ext pt 75 m | Description: Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2014 | Post-d/c care plan overs 30m | Description: Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2015 | Post-d/c care plan overs 60m | Description: Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.) |
| G2020 | Hi inten serv for sip model | Description: Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill with chronic care management codes) |
| G2021 | Hea care pract tx in place | Description: Health care practitioners rendering treatment in place (tip) |
| G2022 | Benef refuses service, mod | Description: A model participant (ambulance supplier/provider), the beneficiary refuses services covered under the model (transport to an alternate destination/treatment in place) |
| 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 |
| G2025 | Dis site tele svcs rhc/fqhc | Description: Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
| 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 |
| G2067 | Med assist tx meth wk | Description: Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2068 | Med assist tx bupre oral | Description: Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2069 | Med assist tx inject | Description: Medication assisted treatment, buprenorphine (injectable) administered on a monthly basis; bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2070 | Med assist tx implant | Description: Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2071 | Med tx remove implant | Description: Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2072 | Med tx insert/remove imp | Description: Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2073 | Med tx naltrexone | Description: Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2074 | Med assist tx no drug | Description: Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2075 | Med tx meds nos | Description: Medication assisted treatment, medication not otherwise specified; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
| G2078 | Take-home meth | Description: Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2079 | Take-hom buprenorphine | Description: Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2080 | Add 30 mins counsel | Description: Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2081 | Pt 66+ snp or ltc pos > 90d | Description: Patients age 66 and older in institutional special needs plans (snp) or residing in long-term care with a pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period |
| G2082 | Visit esketamine 56m or less | Description: Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation |
| G2083 | Visit esketamine, > 56m | Description: Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation |
| G2086 | Off base opioid tx 70min | Description: Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month |
| G2087 | Off base opioid tx, 60 m | Description: Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month |
| G2088 | Off base opioid tx, add30 | Description: Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure) |
| G2089 | A1c level 7 to 9% | Description: Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0% |
| G2090 | 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 |
| G2091 | 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 an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2092 | Ace arb arni | Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy prescribed or currently being taken |
| G2093 | Med doc rsn no ace arn arni | Description: Documentation of medical reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons) |
| G2094 | Pt rsn no ace arn arni | Description: Documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons) |
| 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) |
| G2096 | No rsn ace arb arni | Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy was not prescribed, reason not given |
| G2097 | Dx uri 3d after other dx | Description: Episodes where the patient had a competing diagnosis on or within three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, chronic sinusitis, infection of the adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti) |
| G2098 | 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 |
| G2099 | 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 an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2100 | 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 |
| G2101 | 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 an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| 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 |
| G2105 | 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 |
| G2106 | 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 |
| G2107 | 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 an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| 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 |
| G2112 | Pred<=5 mg ra glu <6m | Description: Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months |
| G2113 | Pred>5 mg >6m, no chg da | Description: Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity |
| 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 |
| G2115 | 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 |
| G2116 | 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 an advanced illness diagnosis 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 |
| G2118 | Pt 81+ frailty | Description: Patients 81 years of age and older with at least one claim/encounter for frailty during 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 |
| G2121 | Psy dep anx ap and icd asse | Description: Depression, anxiety, apathy, and psychosis assessed |
| G2122 | Psy/dep/anx/apandicd noasse | Description: Depression, anxiety, apathy, and psychosis not assessed |
| 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 |
| G2125 | Pt 81+ frailty | Description: Patients 81 years of age and older with at least one claim/encounter for frailty during the six months prior to the measurement period through december 31 of the measurement period |
| G2126 | 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 an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G2127 | 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 |
| G2128 | No aspirin med rsn | Description: Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g. history of gastrointestinal bleed, intra-cranial bleed, blood disorders, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period) |
| G2129 | No bp outpt | Description: Procedure-related bp's not taken during an outpatient visit. examples include same day surgery, ambulatory service center, g.i. lab, dialysis, infusion center, chemotherapy |
| 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 |
| G2136 | Bk pain vas 6-20wk <= 3 | Description: Back pain measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater |
| G2137 | Bk pain vas 6-20wk > 3 | Description: Back pain measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated improvement of less than 5.0 points |
| G2138 | Bk pain vas 9-15mo <= 3 | Description: Back pain as measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater |
| G2139 | Bk pain vas 9-15mo > 3 | Description: Back pain measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated improvement of less than 5.0 points |
| G2140 | Leg pain vas 6-20wk <= 3 | Description: Leg pain measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater |
| G2141 | Leg pain vas 6-20wk > 3 | Description: Leg pain measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated improvement of less than 5.0 points |
| G2142 | Fs odi 9-15mo postop<= 22 | Description: Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 30 points or greater |
| G2143 | Fs odi 9-15mo > 22 | Description: Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of less than 30 points |
| G2144 | Fs odi 6-20wk postop <= 22 | Description: Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6-20 weeks) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at three months (6-20 weeks) postoperatively demonstrated an improvement of 30 points or greater |
| G2145 | Fsodi 6-20wk >22 or chg 30pt | Description: Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of less than 30 points |
| G2146 | Leg pain vas 9-15mo <= 3 | Description: Leg pain as measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater |
| G2147 | Leg pain vas 9-15mo > 3 | Description: Leg pain measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated improvement of less than 5.0 points |
| G2148 | Mpm used | Description: Multimodal pain management was used |
| G2149 | No mpm med rsn | Description: Documentation of medical reason(s) for not using multimodal pain management (e.g., allergy to multiple classes of analgesics, intubated patient, hepatic failure, patient reports no pain during pacu stay, other medical reason(s)) |
| G2150 | No mpm | Description: Multimodal pain management was not used |
| G2151 | Dx degen neuro | Description: Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care |
| G2152 | Res change sc >=0 | Description: Residual score for the neck impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| 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 |
| G2167 | Res change sc < 0 | Description: Residual score for the neck impairment successfully calculated and the score was less than zero (< 0) |
| G2168 | Svs by pt in home health | Description: Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes |
| G2169 | Svs by ot in home health | Description: Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes |
| 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 |
| G2172 | Tx for opioid use demo proj | Description: All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project |
| G2173 | Uri w comorb 12m oth dx | Description: Uri episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
| G2174 | Uri new rx antibiotic 30d | Description: Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date |
| G2175 | Pt comorb dx 12m of epi | Description: Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
| G2176 | Outpt ed obs w inpt admit | Description: Outpatient, ed, or observation visits that result in an inpatient admission |
| G2177 | Bronch w rx antibx 30d | Description: Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date |
| G2178 | Pt not elig low neuro ex | Description: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, alzheimer's, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation |
| G2179 | Med doc rsn no low ex | Description: Clinician documented that patient had medical reason for not performing lower extremity neurological exam |
| G2180 | Inelig footwr eval | Description: Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee |
| G2181 | Bmi not doc medrsn ptref | Description: Bmi not documented due to medical reason or patient refusal of height or weight measurement |
| G2182 | Pt 1st biolog antirheum | Description: Patient receiving first-time biologic and/or immune response modifier therapy |
| G2183 | Doc pt unable comm | Description: Documentation patient unable to communicate and informant not available |
| G2184 | No caregiver | Description: Patient does not have a caregiver |
| G2185 | Caregiver dem trained | Description: Documentation caregiver is trained and certified in dementia care |
| G2186 | Pt ref app rsrcs | Description: Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed |
| G2187 | Clin ind img hd trauma | Description: Patients with clinical indications for imaging of the head: head trauma |
| G2188 | Pt 50 yrs w/clin ind hd | Description: Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age |
| G2189 | Img hd abnml neuro exam | Description: Patients with clinical indications for imaging of the head: abnormal neurologic exam |
| G2190 | Ind img hd rad neck | Description: Patients with clinical indications for imaging of the head: headache radiating to the neck |
| G2191 | Ind img hd pos hd ache | Description: Patients with clinical indications for imaging of the head: positional headaches |
| G2192 | >55 yrs temp hd ache | Description: Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age |
| G2193 | <6yr new onset hd ache | Description: Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) |
| G2194 | New hdache ped pt dis | Description: Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior |
| G2195 | Occip hdache child | Description: Patients with clinical indications for imaging of the head: occipital headache in children |
| G2196 | Screen unhlthy etoh use | Description: Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
| G2197 | Screen hlthy etoh use | Description: Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user |
| 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) |
| G2199 | Not scrn etoh no rsn | Description: Patient not screened for unhealthy alcohol use using a systematic screening method |
| G2200 | Unhlthy etoh rcvd couns | Description: Patient identified as an unhealthy alcohol user received brief counseling |
| 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) |
| G2202 | No rsn no brief couns | Description: Patient did not receive brief counseling if identified as an unhealthy alcohol user |
| 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) |
| G2204 | Pt 45-85 w/ scope | Description: Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period |
| G2205 | Preg drng adjv trtmt | Description: Patients with pregnancy during adjuvant treatment course |
| G2206 | Adjv trtmt chemo her2 | Description: Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy |
| G2207 | Rsn no trtmt chem her2 | Description: Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky <=50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course) |
| G2208 | No trtmt chemo and her2 | Description: Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy |
| G2209 | Refused to participate | Description: Patient refused to participate |
| G2210 | No neck fs prom no rsn | Description: Residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given |
| G2211 | Complex e/m visit add on | Description: Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
| G2212 | Prolong outpt/office vis | Description: Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) |
| G2213 | Initiat med assist tx in er | Description: Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure) |
| G2214 | Init/sub psych care m 1st 30 | Description: Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional |
| G2215 | Home supply nasal naloxone | Description: Take-home supply of nasal naloxone; 2-pack of 4mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2216 | Home supply inject naloxon | Description: Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G2250 | Remot img sub by pt, non e/m | Description: Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment |
| G2251 | Brief chkin, 5-10, non-e/m | Description: Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion |
| G2252 | Brief chkin by md/qhp, 11-20 | Description: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion |
| G3001 | Admin + supply, tositumomab | Description: Administration and supply of tositumomab, 450 mg |
| G3002 | Chronic pain mgmt 30 mins | Description: Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) |
| G3003 | Chronic pain mgmt addl 15m | Description: Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.) |
| G4000 | Dermatology ss | Description: Dermatology mips specialty set |
| G4001 | Diagnostic rad ss | Description: Diagnostic radiology mips specialty set |
| G4002 | Ep cardio ss | Description: Electrophysiology cardiac specialist mips specialty set |
| G4003 | Emergency med ss | Description: Emergency medicine mips specialty set |
| G4004 | Endocrinology ss | Description: Endocrinology mips specialty set |
| G4005 | Family medicine ss | Description: Family medicine mips specialty set |
| G4006 | Gastroenterology ss | Description: Gastro-enterology mips specialty set |
| G4007 | General surgery ss | Description: General surgery mips specialty set |
| G4008 | Geriatrics ss | Description: Geriatrics mips specialty set |
| G4009 | Hospitalists ss | Description: Hospitalists mips specialty set |
| G4010 | Infectious disease ss | Description: Infectious disease mips specialty set |
| G4011 | Internal medicine ss | Description: Internal medicine mips specialty set |
| G4012 | Interventional rad ss | Description: Interventional radiology mips specialty set |
| G4013 | Mntal/behav/psych hlth ss | Description: Mental/behavioral and psychiatry mips specialty set |
| G4014 | Nephrology ss | Description: Nephrology mips specialty set |
| G4015 | Neurology ss | Description: Neurology mips specialty set |
| G4016 | Neurosurgical ss | Description: Neurosurgical mips specialty set |
| G4017 | Nutrition/dietician ss | Description: Nutrition/dietician mips specialty set |
| G4018 | Ob/gyn ss | Description: Obstetrics/gynecology mips specialty set |
| G4019 | Oncology/hema ss | Description: Oncology/hematology mips specialty set |
| G4020 | Ophthalmology/optometry ss | Description: Ophthalmology/optometry mips specialty set |
| G4021 | Orthopedic surgery ss | Description: Orthopedic surgery mips specialty set |
| G4022 | Otolaryngology ss | Description: Otolaryngology mips specialty set |
| G4023 | Pathology ss | Description: Pathology mips specialty set |
| G4024 | Pediatrics ss | Description: Pediatrics mips specialty set |
| G4025 | Physical medicine ss | Description: Physical medicine mips specialty set |
| G4026 | Phys/occ therapy ss | Description: Physical therapy/occupational therapy mips specialty set |
| G4027 | Plastic surgery ss | Description: Plastic surgery mips specialty set |
| G4028 | Podiatry ss | Description: Podiatry mips specialty set |
| G4029 | Preventive medicine ss | Description: Preventive medicine mips specialty set |
| G4030 | Pulmonology ss | Description: Pulmonology mips specialty set |
| G4031 | Radiation oncology ss | Description: Radiation oncology mips specialty set |
| G4032 | Rheumatology ss | Description: Rheumatology mips specialty set |
| G4033 | Skilled nursing facility ss | Description: Skilled nursing facility mips specialty set |
| G4034 | Speech language path ss | Description: Speech language pathology mips specialty set |
| G4035 | Thoracic surgery ss | Description: Thoracic surgery mips specialty set |
| G4036 | Urgent care ss | Description: Urgent care mips specialty set |
| G4037 | Urology ss | Description: Urology mips specialty set |
| G4038 | Vascular surgery ss | Description: Vascular surgery mips specialty set |
| 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 |
| G8395 | Lvef>=40% doc normal or mild | Description: Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function |
| G8396 | Lvef not performed | Description: Left ventricular ejection fraction (lvef) not performed or documented |
| G8397 | Dil macula/fundus exam/w doc | Description: Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
| G8398 | Dil macular/fundus not perfo | Description: Dilated macular or fundus exam not performed |
| G8399 | Pt w/dxa results document | Description: Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed |
| G8400 | Pt w/dxa no results doc | Description: Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given |
| G8401 | Pt inelig osteo screen measu | Description: Clinician documented that patient was not an eligible candidate for screening |
| G8404 | Low extemity neur exam docum | Description: Lower extremity neurological exam performed and documented |
| G8405 | Low extemity neur not perfor | Description: Lower extremity neurological exam not performed |
| G8406 | Pt inelig lower extrem neuro | Description: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure |
| G8410 | Eval on foot documented | Description: Footwear evaluation performed and documented |
| G8415 | Eval on foot not performed | Description: Footwear evaluation was not performed |
| G8416 | Pt inelig footwear evaluatio | Description: Clinician documented that patient was not an eligible candidate for footwear evaluation measure |
| G8417 | Calc bmi abv up param f/u | Description: Bmi is documented above normal parameters and a follow-up plan is documented |
| G8418 | Calc bmi blw low param f/u | Description: Bmi is documented below normal parameters and a follow-up plan is documented |
| G8419 | Calc bmi out nrm param nof/u | Description: Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
| G8420 | Calc bmi norm parameters | Description: Bmi is documented within normal parameters and no follow-up plan is required |
| G8421 | Bmi not calculated | Description: Bmi not documented and no reason is given |
| G8422 | Pt inelig bmi calculation | Description: Bmi not documented, documentation the patient is not eligible for bmi calculation |
| G8427 | Docrev cur meds by elig clin | Description: Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
| G8428 | Cur meds not document | Description: Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
| G8431 | Pos clin depres scrn f/u doc | Description: Screening for depression is documented as being positive and a follow-up plan is documented |
| G8432 | Dep scr not doc, rng | Description: Depression screening not documented, reason not given |
| G8433 | Scr for dep not cpt doc rsn | Description: Screening for depression not completed, documented patient or medical reason |
| 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 |
| G8450 | Beta-bloc rx pt w/abn lvef | Description: Beta-blocker therapy prescribed |
| G8451 | Pt w/abn lvef inelig b-bloc | Description: Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons) |
| G8452 | Pt w/abn lvef b-bloc no rx | Description: Beta-blocker therapy not prescribed |
| 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 |
| G8465 | High risk recurrence pro ca | Description: High or very high risk of recurrence of prostate cancer |
| G8473 | Ace/arb thxpy rx'd | Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed |
| G8474 | Ace/arb not rx'd; doc reas | Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) |
| G8475 | Ace/arb thxpy not rx'd | Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given |
| G8476 | Bp sys <140 and dias <90 | Description: Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg |
| G8477 | Bp sys>=140 and/or dias >=90 | Description: Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg |
| G8478 | Bp not performed/doc | Description: Blood pressure measurement not performed or documented, reason not given |
| G8482 | Flu immunize order/admin | Description: Influenza immunization administered or previously received |
| G8483 | Flu imm no admin doc rea | Description: Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
| G8484 | Flu immunize no admin | Description: Influenza immunization was not administered, reason not given |
| 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 |
| G8510 | Scr dep neg, no plan reqd | Description: Screening for depression is documented as negative, a follow-up plan is not required |
| G8511 | Scr dep pos, no plan doc rng | Description: Screening for depression documented as positive, 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 |
| G8535 | Eld maltreatment not doc | Description: Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter related to one of the following reasons: (1) patient refuses to participate in the screening and has reasonable decisional capacity for self-protection, or (2) patient is in an urgent or emergent situation where time is of the essence and to delay treatment to perform the screening would jeopardize the patient's health status |
| G8536 | No doc elder mal scrn | Description: No documentation of an elder maltreatment screen, reason not given |
| G8539 | Doc funct and care plan | Description: Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
| G8540 | Foa not doc as being perf | Description: Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter |
| G8541 | No doc cur funct assess | Description: Functional outcome assessment using a standardized tool not documented, reason not given |
| G8542 | Doc funct no deficiencies | Description: Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
| G8543 | Cur funct asses; no care pln | Description: Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, 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 |
| G8559 | Pt ref doc oto eval | Description: Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation |
| G8560 | Pt hx act drain prev 90 days | Description: Patient has a history of active drainage from the ear within the previous 90 days |
| G8561 | Pt inelig for ref oto eval | Description: Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure |
| G8562 | Pt no hx act drain 90 d | Description: Patient does not have a history of active drainage from the ear within the previous 90 days |
| G8563 | Pt no ref oto reas no spec | Description: Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given |
| G8564 | Pt ref oto eval | Description: Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified) |
| G8565 | Ver doc hear loss | Description: Verification and documentation of sudden or rapidly progressive hearing loss |
| G8566 | Pt inelig ref oto eval | Description: Patient is not eligible for the 'referral for otologic evaluation for sudden or rapidly progressive hearing loss' measure |
| G8567 | Pt no doc hear loss | Description: Patient does not have verification and documentation of sudden or rapidly progressive hearing loss |
| G8568 | Pt no ref otolo no spec | Description: Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given |
| G8569 | Prol intubation req | Description: Prolonged postoperative intubation (> 24 hrs) required |
| G8570 | No prol intub req | Description: Prolonged postoperative intubation (> 24 hrs) not required |
| 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 |
| G8575 | Postop ren fail | Description: Developed postoperative renal failure or required dialysis |
| G8576 | No postop ren fail | Description: No postoperative renal failure/dialysis not required |
| G8577 | Reop req bld grft oth | Description: Re-exploration required due to mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native, vessel, graft, or both), valve dysfunction, aortic reintervention, or other cardiac reason |
| G8578 | No reop req bld grft oth | Description: Re-exploration not required due to mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native, vessel, graft, or both), valve dysfunction, aortic reintervention, or other cardiac reason |
| 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 |
| G8598 | Asa/antiplat ther used | Description: Aspirin or another antiplatelet therapy used |
| G8599 | No asa/antiplat ther use rng | Description: Aspirin or another antiplatelet therapy not used, reason not given |
| G8600 | Tpa initi w/in 4.5 hr | Description: Iv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well |
| G8601 | No elig tpa init w/in 4.5 hr | Description: Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention) |
| G8602 | No tpa init w/in 4.5 hr | Description: Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well, reason not given |
| 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 |
| G8633 | Pharm ther osteo rx | Description: Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed |
| G8634 | Pt no elg phar ther osteo | Description: Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis |
| G8635 | No pharm ther osteo rx | Description: Pharmacologic therapy for osteoporosis was not prescribed, reason not given |
| 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 |
| G8647 | Rafscrs ki scor >= 0 | Description: Residual score for the knee impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8648 | Rafscrs ki scor < 0 | Description: Residual score for the knee impairment successfully calculated and the score was less than zero (< 0) |
| 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 |
| G8650 | Rafs crs ki no scor no rsn | Description: Residual score for the knee impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given |
| G8651 | Rafscrs hi scor >=0 | Description: Residual score for the hip impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8652 | Rafscrs hi scor < 0 | Description: Residual score for the hip impairment successfully calculated and the score was less than zero (< 0) |
| 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 |
| G8654 | Rafs crs hi no scor no surv | Description: Residual score for the hip impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given |
| G8655 | Rafscrs llfai scor >= 0 | Description: Residual score for the lower leg, foot or ankle impairment successfully calculated and the score was equal to zero (0) or greater than zero ( > 0) |
| G8656 | Rafscrs llfai scor < 0 | Description: Residual score for the lower leg, foot or ankle impairment successfully calculated and the score was less than zero (< 0) |
| 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 |
| G8658 | Rafscrs llfai no scor + surv | Description: Residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given |
| G8659 | Rafscrs lbi scor >= 0 | Description: Residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8660 | Rafscrs lbi scor < 0 | Description: Residual score for the low back impairment successfully calculated and the score was less than zero (< 0) |
| G8661 | Rafscrs lbi no scor | Description: Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate |
| G8662 | Rafs crs lbi no scor no surv | Description: Residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given |
| G8663 | Rafscrs si scor >= 0 | Description: Residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8664 | Rafscrs si scor < 0 | Description: Residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0) |
| 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 |
| G8666 | Rafs crs si no scor no surv | Description: Residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given |
| G8667 | Rafscrs ewh scor >= 0 | Description: Residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
| G8668 | Rafscrs ewh scor < 0 | Description: Residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0) |
| 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 |
| G8670 | Rafs crs ewh no scor no surv | Description: Residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given |
| 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 |
| G8694 | Lvef <=40% | Description: Current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd |
| 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 |
| G8708 | Antibiotic not pres | Description: Patient not prescribed antibiotic |
| G8709 | Uri ep compete diag | Description: Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) |
| G8710 | Pt pres antibiotic | Description: Patient prescribed antibiotic |
| G8711 | Pres antibx on/within 3 day | Description: Prescribed antibiotic on or within 3 days after the episode date |
| G8712 | Not pres antibiotic | Description: Antibiotic not prescribed or dispensed |
| 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]) |
| G8721 | Pt, pn, hist grade doc | Description: Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report |
| G8722 | Med reas pt, pn, not doc | Description: Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal) |
| G8723 | Spec sit not prim tumor | Description: Specimen site is other than anatomic location of primary tumor |
| G8724 | Pt, pn, hist grade not doc | Description: Pt category, pn category and histologic grade were not documented in the pathology report, reason not given |
| 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 |
| G8733 | Doc pos elder mal scrn plan | Description: Elder maltreatment screen documented as positive and a follow-up plan is documented |
| G8734 | Doc neg eld req | Description: Elder maltreatment screen documented as negative, follow-up is not required |
| G8735 | Eld mal scrn pos no plan | Description: Elder maltreatment screen documented as positive, follow-up plan not documented, 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 |
| G8749 | No signs melanoma | Description: Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma) |
| G8751 | Smkg status not assess | Description: Smoking status and exposure to second hand smoke in the home not assessed, reason not given |