List of HCPCS codes for: Temporary Procedures & Professional Services (G-codes)

HCPCS Code	Short Description	Long Description
G0	Telestroke	Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke
G0008	Admin influenza virus vac	Administration of influenza virus vaccine
G0009	Admin pneumococcal vaccine	Administration of pneumococcal vaccine
G0010	Admin hepatitis b vaccine	Administration of hepatitis b vaccine
G0011	Hiv prep counsel, md 15-30m	Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes
G0012	Injection of hiv prep drug	Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle
G0013	Hiv prep counsel, clin staff	Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence
G0017	Crisis psychotherapy 60m	Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes
G0018	Crisis psychotherapy add 30m	Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)
G0019	Comm hlth intg svs sdoh 60mn	Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(s) that are significantly limiting the ability to diagnose or treat problem(s) addressed in an initiating visit: person-centered assessment, performed to better understand the individualized context of the intersection between the sdoh need(s) and the problem(s) addressed in the initiating visit. ++ conducting a person-centered assessment to understand patient's life story, strengths, needs, goals, preferences and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal-setting and establishing an action plan. ++ providing tailored support to the patient as needed to accomplish the practitioner's treatment plan. practitioner, home-, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; and from home- and community-based service providers, social service providers, and caregiver (if applicable). ++ communication with practitioners, home- and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) to address the sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, and preferences, in the context of the sdoh need(s), and educating the patient on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services addressing the sdoh need(s), in ways that are more likely to promote personalized and effective diagnosis or treatment. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care and helping secure appointments with them. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the problem(s) addressed in the initiating visit, the sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leveraging lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals
G0022	Comm hlth intg svs add 30 m	Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)
G0023	Pin service 60m per month	Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered assessment to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; home- and community-based service providers; and caregiver (if applicable). ++ communication with practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care, and helping secure appointments with them. ++ providing the patient with information/resources to consider participation in clinical trials or clinical research as applicable. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals
G0024	Pin srv add 30 min pr m	Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)
G0027	Semen analysis	Semen analysis; presence and/or motility of sperm excluding huhner
G0028	Doc med rsn no scr tob	Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
G0029	No tob scr/cess int	Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period
G0030	Pt scr tob & cess int	Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user
G0031	Pall serv during meas	Palliative care services given to patient any time during the measurement period
G0032	2+ antipsy schiz	Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics
G0033	2+ benzo seiz	Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement period and the ipsd for benzodiazepines
G0034	Pall serv during meas	Patients receiving palliative care during the measurement period
G0035	Pt ed pos 23	Patient has any emergency department encounter during the performance period with place of service indicator 23
G0036	Pt/ptn decln assess	Patient or care partner decline assessment
G0037	Pt not able to participate	On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available
G0038	Clin pt no ref	Clinician determines patient does not require referral
G0039	Pt no ref, rn spec	Patient not referred, reason not otherwise specified
G0040	Pt phys/occ therapy	Patient already receiving physical/occupational/speech/recreational therapy during the measurement period
G0041	Pt/ptn decln referral	Patient and/or care partner decline referral
G0042	Ref to therapy	Referral to physical, occupational, speech, or recreational therapy
G0043	Pt mech pros ht valv	Patients with mechanical prosthetic heart valve
G0044	Pt mitral stenosis	Patients with moderate or severe mitral stenosis
G0045	Mrs 90 days post stk	Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention
G0046	No mrs 90 days post stk	Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention
G0047	Ped blunt hd traum	Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed
G0048	Pall serv during meas	Patients who receive palliative care services any time during the intake period through the end of the measurement year
G0049	Main hemo in-cntr	With maintenance hemodialysis (in-center and home hd) for the complete reporting month
G0050	Pt w/ lmted life expec	Patients with a catheter that have limited life expectancy
G0051	Pt hospice mnth	Patients under hospice care in the current reporting month
G0052	Pt peri dialysis dur mo	Patients on peritoneal dialysis for any portion of the reporting month
G0053	Adv rheum pt care mvp	Advancing rheumatology patient care mips value pathways
G0054	Strk cr prev pos outcme mvp	Coordinating stroke care to promote prevention and cultivate positive outcomes mips value pathways
G0055	Adv care heart dx mvp	Advancing care for heart disease mips value pathways
G0056	Opt chronic dx mang mvp	Optimizing chronic disease management mips value pathways
G0057	Best pct pt safety em mvp	Proposed adopting best practices and promoting patient safety within emergency medicine mips value pathways
G0058	Imprv care le jnt repr mvp	Improving care for lower extremity joint repair mips value pathways
G0059	Pt sfty pos exp w aneth mvp	Patient safety and support of positive experiences with anesthesia mips value pathways
G0060	Allergy/immunology ss	Allergy/immunology mips specialty set
G0061	Anesthesiology ss	Anesthesiology mips specialty set
G0062	Audiology ss	Audiology mips specialty set
G0063	Cardiology ss	Cardiology mips specialty set
G0064	Cert nurse midwife ss	Certified nurse midwife mips specialty set
G0065	Chiropractic ss	Chiropractic medicine mips specialty set
G0066	Clinical social work ss	Clinical social work mips specialty set
G0067	Dentistry ss	Dentistry mips specialty set
G0068	Adm iv infusion drug in home	Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0069	Adm sq infusion drug in home	Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0070	Adm of chemo drug in home	Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0071	Comm svcs by rhc/fqhc 5 min	Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only
G0076	Care manag h vst new pt 20 m	Brief (20 minutes) care management home visit for a new patient. 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)
G0077	Care manag h vst new pt 30 m	Limited (30 minutes) care management home visit for a new patient. 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)
G0078	Care manag h vst new pt 45 m	Moderate (45 minutes) care management home visit for a new patient. 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)
G0079	Care manag h vst new pt 60 m	Comprehensive (60 minutes) care management home visit for a new patient. 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)
G0080	Care manag h vst new pt 75 m	Extensive (75 minutes) care management home visit for a new patient. 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)
G0081	Care man h v ext pt 20 mi	Brief (20 minutes) care management home visit for an existing patient. 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)
G0082	Care man h v ext pt 30 m	Limited (30 minutes) care management home visit for an existing patient. 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)
G0083	Care man h v ext pt 45 m	Moderate (45 minutes) care management home visit for an existing patient. 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)
G0084	Care man h v ext pt 60 m	Comprehensive (60 minutes) care management home visit for an existing patient. 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)
G0085	Care man h v ext pt 75 m	Extensive (75 minutes) care management home visit for an existing patient. 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)
G0086	Care man home care plan 30 m	Limited (30 minutes) care management 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)
G0087	Care man home care plan 60 m	Comprehensive (60 minutes) care management 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)
G0088	Adm iv drug 1st home visit	Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0089	Adm subq drug 1st home visit	Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0090	Adm iv chemo 1st home visit	Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0101	Ca screen;pelvic/breast exam	Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0102	Prostate ca screening; dre	Prostate cancer screening; digital rectal examination
G0103	Psa screening	Prostate cancer screening; prostate specific antigen test (psa)
G0104	Ca screen;flexi sigmoidscope	Colorectal cancer screening; flexible sigmoidoscopy
G0105	Colorectal scrn; hi risk ind	Colorectal cancer screening; colonoscopy on individual at high risk
G0106	Colon ca screen;barium enema	Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
G0108	Diab manage trn per indiv	Diabetes outpatient self-management training services, individual, per 30 minutes
G0109	Diab manage trn ind/group	Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
G0117	Glaucoma scrn hgh risk direc	Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
G0118	Glaucoma scrn hgh risk direc	Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
G0120	Colon ca scrn; barium enema	Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
G0121	Colon ca scrn not hi rsk ind	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
G0122	Colon ca scrn; barium enema	Colorectal cancer screening; barium enema
G0123	Screen cerv/vag thin layer	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
G0124	Screen c/v thin layer by md	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
G0127	Trim nail(s)	Trimming of dystrophic nails, any number
G0128	Corf skilled nursing service	Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes
G0129	Php/iop ot service	Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)
G0130	Single energy x-ray study	Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
G0136	Adm of soc dtr assess 5-15 m	Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes
G0137	Inten outpt svs,min 9 pr 7 d	Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
G0138	Iv cipaglucosidase alfa-atga	Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga
G0140	Nav srv peer sup 60 min pr m	Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors, and including unmet sdoh needs (that are not billed separately). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the person-centered goals in the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care communication. ++ assist the patient in communicating with their practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education. helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. developing and proposing strategies to help meet person-centered treatment goals and supporting the patient in using chosen strategies to reach person-centered treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet person-centered diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals
G0141	Scr c/v cyto,autosys and md	Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
G0143	Scr c/v cyto,thinlayer,rescr	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
G0144	Scr c/v cyto,thinlayer,rescr	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
G0145	Scr c/v cyto,thinlayer,rescr	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
G0146	Nav srv peer sup add 30 pr m	Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)
G0147	Scr c/v cyto, automated sys	Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
G0148	Scr c/v cyto, autosys, rescr	Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
G0151	Hhcp-serv of pt,ea 15 min	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes
G0152	Hhcp-serv of ot,ea 15 min	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes
G0153	Hhcp-svs of s/l path,ea 15mn	Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes
G0154	Hhcp-svs of rn,ea 15 min	Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes
G0155	Hhcp-svs of csw,ea 15 min	Services of clinical social worker in home health or hospice settings, each 15 minutes
G0156	Hhcp-svs of aide,ea 15 min	Services of home health/hospice aide in home health or hospice settings, each 15 minutes
G0157	Hhc pt assistant ea 15	Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes
G0158	Hhc ot assistant ea 15	Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes
G0159	Hhc pt maint ea 15 min	Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes
G0160	Hhc occup therapy ea 15	Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
G0161	Hhc slp ea 15 min	Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes
G0162	Hhc rn e&m plan svs, 15 min	Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)
G0163	Hhc lpn/rn obs/asses ea 15	Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0164	Hhc lis nurse train ea 15	Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0166	Extrnl counterpulse, per tx	External counterpulsation, per treatment session
G0168	Wound closure by adhesive	Wound closure utilizing tissue adhesive(s) only
G0173	Linear acc stereo radsur com	Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session
G0175	Opps service,sched team conf	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present
G0176	Opps/php/iop; activity thrpy	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
G0177	Opps/php/iop; train & educ	Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)
G0179	Md recertification hha pt	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care
G0180	Md certification hha patient	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care
G0181	Home health care supervision	Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans
G0182	Hospice care supervision	Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
G0186	Dstry eye lesn,fdr vssl tech	Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)
G0202	Scr mammo bi incl cad	Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
G0204	Dx mammo incl cad bi	Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
G0206	Dx mammo incl cad uni	Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
G0219	Pet img wholbod melano nonco	Pet imaging whole body; melanoma for non-covered indications
G0235	Pet not otherwise specified	Pet imaging, any site, not otherwise specified
G0237	Therapeutic procd strg endur	Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
G0238	Oth resp proc, indiv	Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
G0239	Oth resp proc, group	Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
G0245	Initial foot exam pt lops	Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education
G0246	Followup eval of foot pt lop	Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
G0247	Routine footcare pt w lops	Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
G0248	Demonstrate use home inr mon	Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
G0249	Provide inr test mater/equip	Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests
G0250	Md inr test revie inter mgmt	Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests
G0251	Linear acc based stero radio	Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment
G0252	Pet imaging initial dx	Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
G0255	Current percep threshold tst	Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve
G0257	Unsched dialysis esrd pt hos	Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility
G0259	Inject for sacroiliac joint	Injection procedure for sacroiliac joint; arthrography
G0260	Inj for sacroiliac jt anesth	Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
G0268	Removal of impacted wax md	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
G0269	Occlusive device in vein art	Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)
G0270	Mnt subs tx for change dx	Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
G0271	Group mnt 2 or more 30 mins	Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
G0276	Pild/placebo control clin tr	Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial
G0277	Hbot, full body chamber, 30m	Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
G0278	Iliac art angio,cardiac cath	Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)
G0279	Tomosynthesis, mammo	Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)
G0281	Elec stim unattend for press	Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
G0282	Elect stim wound care not pd	Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281
G0283	Elec stim other than wound	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
G0288	Recon, cta for surg plan	Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
G0289	Arthro, loose body + chondro	Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
G0293	Non-cov surg proc,clin trial	Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day
G0294	Non-cov proc, clinical trial	Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day
G0295	Electromagnetic therapy onc	Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses
G0296	Visit to determ ldct elig	Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
G0297	Ldct for lung ca screen	Low dose ct scan (ldct) for lung cancer screening
G0299	Hhs/hospice of rn ea 15 min	Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes
G0300	Hhs/hospice of lpn ea 15 min	Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes
G0302	Pre-op service lvrs complete	Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
G0303	Pre-op service lvrs 10-15dos	Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
G0304	Pre-op service lvrs 1-9 dos	Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
G0305	Post op service lvrs min 6	Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
G0306	Cbc/diffwbc w/o platelet	Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
G0307	Cbc without platelet	Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
G0308	180 d implant glucose sensor	Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training
G0309	Rem/inser glu sensor dif sit	Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
G0310	Immunize counsel 5-15 min	Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)
G0311	Immunize counsel 16-30 mins	Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)
G0312	Immunize couns < 21yr 5-15 m	Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)
G0313	Immunize couns < 21yr 6-30 m	Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)
G0314	Counsel immune <21 16-30 m	Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
G0315	Counsel immune <21 5-15 m	Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
G0316	Prolong inpt eval add15 m	Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using 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 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes)
G0317	Prolong nursin fac eval 15m	Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using 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 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes)
G0318	Prolong home eval add 15m	Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using 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 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes)
G0320	Two-way audio and video hhs	Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system
G0321	Audio-only hhs	Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
G0322	Home h physio data collec tr	The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)
G0323	Care manage beh svs 20mins	Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team)
G0327	Colon ca scrn;bld-bsd biomrk	Colorectal cancer screening; blood-based biomarker
G0328	Fecal blood scrn immunoassay	Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous
G0329	Electromagntic tx for ulcers	Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
G0330	Facility svs dental rehab	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room
G0333	Dispense fee initial 30 day	Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary
G0337	Hospice evaluation preelecti	Hospice evaluation and counseling services, pre-election
G0339	Robot lin-radsurg com, first	Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
G0340	Robt lin-radsurg fractx 2-5	Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment
G0341	Percutaneous islet celltrans	Percutaneous islet cell transplant, includes portal vein catheterization and infusion
G0342	Laparoscopy islet cell trans	Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion
G0343	Laparotomy islet cell transp	Laparotomy for islet cell transplant, includes portal vein catheterization and infusion
G0364	Bone marrow aspirate &biopsy	Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
G0365	Vessel mapping hemo access	Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)
G0372	Md service required for pmd	Physician service required to establish and document the need for a power mobility device
G0378	Hospital observation per hr	Hospital observation service, per hour
G0379	Direct refer hospital observ	Direct admission of patient for hospital observation care
G0380	Lev 1 hosp type b ed visit	Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0381	Lev 2 hosp type b ed visit	Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0382	Lev 3 hosp type b ed visit	Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0383	Lev 4 hosp type b ed visit	Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0384	Lev 5 hosp type b ed visit	Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0389	Ultrasound exam aaa screen	Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
G0390	Trauma respons w/hosp criti	Trauma response team associated with hospital critical care service
G0396	Alcohol/subs interv 15-30mn	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
G0397	Alcohol/subs interv >30 min	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes
G0398	Home sleep test/type 2 porta	Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation
G0399	Home sleep test/type 3 porta	Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation
G0400	Home sleep test/type 4 porta	Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels
G0402	Initial preventive exam	Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0403	Ekg for initial prevent exam	Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
G0404	Ekg tracing for initial prev	Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
G0405	Ekg interpret & report preve	Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
G0406	Inpt/tele follow up 15	Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
G0407	Inpt/tele follow up 25	Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth
G0408	Inpt/tele follow up 35	Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth
G0409	Corf related serv 15 mins ea	Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)
G0410	Grp psych php/iop 45-50	Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes
G0411	Interactive grp psyc php/iop	Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes
G0412	Open tx iliac spine uni/bil	Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed
G0413	Pelvic ring fracture uni/bil	Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)
G0414	Pelvic ring fx treat int fix	Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)
G0415	Open tx post pelvic fxcture	Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)
G0416	Prostate biopsy, any mthd	Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
G0417	Sat biopsy prostate 21-40	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens
G0418	Sat biopsy prostate 41-60	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens
G0419	Sat biopsy prostate: >60	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens
G0420	Ed svc ckd ind per session	Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
G0421	Ed svc ckd grp per session	Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
G0422	Intens cardiac rehab w/exerc	Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
G0423	Intens cardiac rehab no exer	Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
G0424	Pulmonary rehab w exer	Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
G0425	Inpt/ed teleconsult30	Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
G0426	Inpt/ed teleconsult50	Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
G0427	Inpt/ed teleconsult70	Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
G0428	Collagen meniscus implant	Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
G0429	Dermal filler injection(s)	Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
G0431	Drug screen multiple class	Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
G0432	Eia hiv-1/hiv-2 screen	Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening
G0433	Elisa hiv-1/hiv-2 screen	Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
G0434	Drug screen multi drug class	Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
G0435	Oral hiv-1/hiv-2 screen	Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
G0436	Tobacco-use counsel 3-10 min	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
G0437	Tobacco-use counsel>10min	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
G0438	Ppps, initial visit	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439	Ppps, subseq visit	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G0442	Annual alcohol screen 15 min	Annual alcohol misuse screening, 5 to 15 minutes
G0443	Brief alcohol misuse counsel	Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
G0444	Depression screen annual	Annual depression screening, 5 to 15 minutes
G0445	High inten beh couns std 30m	High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
G0446	Intens behave ther cardio dx	Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
G0447	Behavior counsel obesity 15m	Face-to-face behavioral counseling for obesity, 15 minutes
G0448	Place perm pacing cardiovert	Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing
G0451	Devlopment test interpt&rep	Development testing, with interpretation and report, per standardized instrument form
G0452	Molecular pathology interpr	Molecular pathology procedure; physician interpretation and report
G0453	Cont intraop neuro monitor	Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
G0454	Md document visit by npp	Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
G0455	Fecal microbiota prep instil	Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
G0456	Neg pre wound <=50 sq cm	Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters
G0457	Neg pres wound >50 sq cm	Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters
G0458	Ldr prostate brachy comp rat	Low dose rate (ldr) prostate brachytherapy services, composite rate
G0459	Telehealth inpt pharm mgmt	Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
G0460	Autolog prp not diab ulcer	Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment
G0461	Immunohisto/cyto chem 1st st	Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
G0462	Immunohisto/cyto chem add	Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)
G0463	Hospital outpt clinic visit	Hospital outpatient clinic visit for assessment and management of a patient
G0464	Colorec ca scr, sto bas dna	Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
G0465	Autolog prp diab wound ulcer	Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)
G0466	Fqhc visit new patient	Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
G0467	Fqhc visit, estab pt	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
G0468	Fqhc visit, ippe or awv	Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv
G0469	Fqhc visit, mh new pt	Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
G0470	Fqhc visit, mh estab pt	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
G0471	Ven blood coll snf/hha	Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)
G0472	Hep c screen high risk/other	Hepatitis c antibody screening, for individual at high risk and other covered indication(s)
G0473	Group behave couns 2-10	Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
G0475	Hiv combination assay	Hiv antigen/antibody, combination assay, screening
G0476	Hpv combo assay ca screen	Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test
G0477	Drug test presump optical	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0478	Drug test presump opt inst	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0479	Drug test presump not opt	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service
G0480	Drug test def 1-7 classes	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed
G0481	Drug test def 8-14 classes	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed
G0482	Drug test def 15-21 classes	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed
G0483	Drug test def 22+ classes	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed
G0490	Home visit rn, lpn by rhc/fq	Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)
G0491	Dialysis acu kidney no esrd	Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd
G0492	Md/oth eval acut kid no esrd	Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd
G0493	Rn care ea 15 min hh/hospice	Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0494	Lpn care ea 15min hh/hospice	Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0495	Rn care train/edu in hh	Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0496	Lpn care train/edu in hh	Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0498	Chemo extend iv infus w/pump	Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion
G0499	Hepb screen high risk indiv	Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result
G0500	Mod sedat endo service >5yrs	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
G0501	Resource-inten svc during ov	Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
G0502	Init psych care manag, 70min	Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies
G0503	Subseq psych care man,60mi	Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment
G0504	Init/sub psych care add 30 m	Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
G0505	Cog/func assessment outpt	Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
G0506	Comp asses care plan ccm svc	Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
G0507	Care manage serv minimum 20	Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team
G0508	Crit care telehea consult 60	Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
G0509	Crit care telehea consult 50	Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
G0511	Ccm/bhi by rhc/fqhc 20min mo	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
G0512	Cocm by rhc/fqhc 60 min mo	Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
G0513	Prolong prev svcs, first 30m	Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
G0514	Prolong prev svcs, addl 30m	Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
G0515	Cognitive skills development	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
G0516	Insert drug del implant, >=4	Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
G0517	Remove drug implant	Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G0518	Remove w insert drug implant	Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G0519	New pt-cg dyad dem low cmplx	Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
G0520	New pt-cg dyad dem mod cmplx	Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
G0521	New pt-cg dyad dem hig cmplx	Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
G0522	Mgt nw pt dementia low cmplx	Management of a new patient with dementia, low complexity, for use in cmmi model
G0523	Mgt nw pt dem mod-high cmplx	Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
G0524	Est pt-cg dyad dem low cmplx	Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
G0525	Est pt-cg dyad dem mod cmplx	Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
G0526	Est pt-cg dyad dem hig cmplx	Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model
G0527	Mgt est pt dmentia low cmplx	Management of established patient with dementia, low complexity, for use in cmmi model
G0528	Mgt est pt dem mod-hi cmplx	Management of established patient with dementia, moderate to high complexity, for use in cmmi model
G0529	In home respite care, 4 hr u	In-home respite care, 4-hour unit, for use in cmmi model
G0530	Adult daycare center, 8 hr u	Adult day center, 8-hour unit, for use in cmmi model
G0531	Fclty-based respite, 24 hr u	Facility-based respite, 24-hour unit, for use in cmmi model
G0659	Drug test def simple all cl	Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes
G0908	Hgb > 12 g/dl	Most recent hemoglobin (hgb) level > 12.0 g/dl
G0909	Hbg not doc	Hemoglobin level measurement not documented, reason not given
G0910	Hgb <= 12 g/dl	Most recent hemoglobin level <= 12.0 g/dl
G0913	Improve visual funct	Improvement in visual function achieved within 90 days following cataract surgery
G0914	Survey not complete	Patient care survey was not completed by patient
G0915	No improve visual funct	Improvement in visual function not achieved within 90 days following cataract surgery
G0916	Satisfy with care	Satisfaction with care achieved within 90 days following cataract surgery
G0917	Care survey not complete	Patient care survey was not completed by patient
G0918	No satisfy with care	Satisfaction with care not achieved within 90 days following cataract surgery
G0919	Flu immunize not avail	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	Type, anatomic location, and activity all documented
G0921	Doc pt reas no assess	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	No documentation of disease type, anatomic location, and activity, reason not given
G1	Urr reading of less than 60	Most recent urr reading of less than 60
G1000	Cdsm applied pathways	Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program
G1001	Cdsm evicore	Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program
G1002	Cdsm medcurrent	Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program
G1003	Cdsm medicalis	Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program
G1004	Cdsm ndsc	Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program
G1005	Cdsm nia	Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program
G1006	Cdsm test approp	Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program
G1007	Cdsm aim	Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program
G1008	Cdsm cranberry pk	Clinical decision support mechanism cranberry peak, as defined by the medicare appropriate use criteria program
G1009	Cdsm sage health	Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program
G1010	Cdsm stanson	Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program
G1011	Cdsm qualified nos	Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program
G1012	Cdsm agilemd	Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria program
G1013	Cdsm evidencecare	Clinical decision support mechanism evidencecare imagingcare, as defined by the medicare appropriate use criteria program
G1014	Cdsm inveniqa	Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria program
G1015	Cdsm reliant	Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria program
G1016	Cdsm speed of care	Clinical decision support mechanism speed of care, as defined by the medicare appropriate use criteria program
G1017	Cdsm healthhelp	Clinical decision support mechanism healthhelp, as defined by the medicare appropriate use criteria program
G1018	Cdsm infinx	Clinical decision support mechanism infinx, as defined by the medicare appropriate use criteria program
G1019	Cdsm logicnets	Clinical decision support mechanism logicnets, as defined by the medicare appropriate use criteria program
G1020	Cdsm curbside	Clinical decision support mechanism curbside clinical augmented workflow, as defined by the medicare appropriate use criteria program
G1021	Cdsm ehealthline	Clinical decision support mechanism ehealthline clinical decision support mechanism, as defined by the medicare appropriate use criteria program
G1022	Cdsm intermountain	Clinical decision support mechanism intermountain clinical decision support mechanism, as defined by the medicare appropriate use criteria program
G1023	Cdsm persivia	Clinical decision support mechanism persivia clinical decision support, as defined by the medicare appropriate use criteria program
G1024	Cdsm radrite	Clinical decision support mechanism radrite, as defined by the medicare appropriate use criteria program
G1025	Pt mnth 1 mcp prov	Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month
G1026	Pt hemo > 3mo	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	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	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
G2	Urr reading of 60 to 64.9	Most recent urr reading of 60 to 64.9
G2000	Blinded conv. tx mdd clin tr	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	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	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	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	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	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	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	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	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	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	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	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	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	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	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	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	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	Health care practitioners rendering treatment in place (tip)
G2022	Benef refuses service, mod	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	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	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	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	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	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	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	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	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	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	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	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	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	Medication assisted treatment, buprenorphine (injectable); 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)
G2070	Med assist tx implant	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	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	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	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	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	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)
G2076	Intake act w/med exam	Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient's short-term goals and the tasks the patient must perform to complete the short-term goals; the patient's requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
G2077	Periodic assessment	Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
G2078	Take-home meth	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	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	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	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	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	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	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	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	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%	Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%
G2090	Pt 66+ frailty and med dem	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	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
G2092	Ace arb arni	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	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	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	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	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	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	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	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
G2100	Pt 66+ frailty and med dem	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	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
G2102	Dil retinal eye exam	Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed
G2103	7 stereo photos interpret	Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed
G2104	Eye img valid w/7 stereo	Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed
G2105	Pt 66+ snp or ltc pos > 90d	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	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	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
G2108	Pt 66+ snp or ltc pos > 90d	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	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	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	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	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	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	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	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
G2117	Pt 66-80 frailty and adv ill	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	Patients 81 years of age and older with at least one claim/encounter for frailty during the measurement period
G2119	Calc vitd opt	Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed
G2120	No calc vitd opt	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	Depression, anxiety, apathy, and psychosis assessed
G2122	Psy/dep/anx/apandicd noasse	Depression, anxiety, apathy, and psychosis not assessed
G2123	Pt 66-80 frailty med dem	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	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	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	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
G2127	Pt 66-80 frailty and med dem	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	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	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	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	Patients 81 years and older with a diagnosis of frailty
G2132	Pt 66-80 frailty and med dem	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	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	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	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	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	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	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	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	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	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	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	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	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	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	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	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	Multimodal pain management was used
G2149	No mpm med rsn	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	Multimodal pain management was not used
G2151	Dx degen neuro	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	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	In hospice or using hospice services during the measurement period
G2154	Td 9 yrs start end meas	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	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	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+	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	Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period
G2159	No pneum vacc 12 mo 60+	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+	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	Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period
G2162	No herpzos 50+	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	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	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	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	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	Residual score for the neck impairment successfully calculated and the score was less than zero (< 0)
G2168	Svs by pt in home health	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	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	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	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	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	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	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	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	Outpatient, ed, or observation visits that result in an inpatient admission
G2177	Bronch w rx antibx 30d	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	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	Clinician documented that patient had medical reason for not performing lower extremity neurological exam
G2180	Inelig footwr eval	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	Bmi not documented due to medical reason or patient refusal of height or weight measurement
G2182	Pt 1st biolog antirheum	Patient receiving first-time biologic and/or immune response modifier therapy
G2183	Doc pt unable comm	Documentation patient unable to communicate and informant not available
G2184	No caregiver	Patient does not have a caregiver
G2185	Caregiver dem trained	Documentation caregiver is trained and certified in dementia care
G2186	Pt ref app rsrcs	Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed
G2187	Clin ind img hd trauma	Patients with clinical indications for imaging of the head: head trauma
G2188	Pt 50 yrs w/clin ind hd	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	Patients with clinical indications for imaging of the head: abnormal neurologic exam
G2190	Ind img hd rad neck	Patients with clinical indications for imaging of the head: headache radiating to the neck
G2191	Ind img hd pos hd ache	Patients with clinical indications for imaging of the head: positional headaches
G2192	>55 yrs temp hd ache	Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age
G2193	<6yr new onset hd ache	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	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	Patients with clinical indications for imaging of the head: occipital headache in children
G2196	Screen unhlthy etoh use	Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method
G2197	Screen hlthy etoh use	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	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	Patient not screened for unhealthy alcohol use using a systematic screening method
G2200	Unhlthy etoh rcvd couns	Patient identified as an unhealthy alcohol user received brief counseling
G2201	Med rsn no brief couns	Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)
G2202	No rsn no brief couns	Patient did not receive brief counseling if identified as an unhealthy alcohol user
G2203	Med rsn no etoh couns	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	Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period
G2205	Preg drng adjv trtmt	Patients with pregnancy during adjuvant treatment course
G2206	Adjv trtmt chemo her2	Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy
G2207	Rsn no trtmt chem her2	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	Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy
G2209	Refused to participate	Patient refused to participate
G2210	No neck fs prom no rsn	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	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	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	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	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	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	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	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	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	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
G3	Urr reading of 65 to 69.9	Most recent urr reading of 65 to 69.9
G3001	Admin + supply, tositumomab	Administration and supply of tositumomab, 450 mg
G3002	Chronic pain mgmt 30 mins	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	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.)
G4	Urr reading of 70 to 74.9	Most recent urr reading of 70 to 74.9
G4000	Dermatology ss	Dermatology mips specialty set
G4001	Diagnostic rad ss	Diagnostic radiology mips specialty set
G4002	Ep cardio ss	Electrophysiology cardiac specialist mips specialty set
G4003	Emergency med ss	Emergency medicine mips specialty set
G4004	Endocrinology ss	Endocrinology mips specialty set
G4005	Family medicine ss	Family medicine mips specialty set
G4006	Gastroenterology ss	Gastro-enterology mips specialty set
G4007	General surgery ss	General surgery mips specialty set
G4008	Geriatrics ss	Geriatrics mips specialty set
G4009	Hospitalists ss	Hospitalists mips specialty set
G4010	Infectious disease ss	Infectious disease mips specialty set
G4011	Internal medicine ss	Internal medicine mips specialty set
G4012	Interventional rad ss	Interventional radiology mips specialty set
G4013	Mntal/behav/psych hlth ss	Mental/behavioral and psychiatry mips specialty set
G4014	Nephrology ss	Nephrology mips specialty set
G4015	Neurology ss	Neurology mips specialty set
G4016	Neurosurgical ss	Neurosurgical mips specialty set
G4017	Nutrition/dietician ss	Nutrition/dietician mips specialty set
G4018	Ob/gyn ss	Obstetrics/gynecology mips specialty set
G4019	Oncology/hema ss	Oncology/hematology mips specialty set
G4020	Ophthalmology/optometry ss	Ophthalmology/optometry mips specialty set
G4021	Orthopedic surgery ss	Orthopedic surgery mips specialty set
G4022	Otolaryngology ss	Otolaryngology mips specialty set
G4023	Pathology ss	Pathology mips specialty set
G4024	Pediatrics ss	Pediatrics mips specialty set
G4025	Physical medicine ss	Physical medicine mips specialty set
G4026	Phys/occ therapy ss	Physical therapy/occupational therapy mips specialty set
G4027	Plastic surgery ss	Plastic surgery mips specialty set
G4028	Podiatry ss	Podiatry mips specialty set
G4029	Preventive medicine ss	Preventive medicine mips specialty set
G4030	Pulmonology ss	Pulmonology mips specialty set
G4031	Radiation oncology ss	Radiation oncology mips specialty set
G4032	Rheumatology ss	Rheumatology mips specialty set
G4033	Skilled nursing facility ss	Skilled nursing facility mips specialty set
G4034	Speech language path ss	Speech language pathology mips specialty set
G4035	Thoracic surgery ss	Thoracic surgery mips specialty set
G4036	Urgent care ss	Urgent care mips specialty set
G4037	Urology ss	Urology mips specialty set
G4038	Vascular surgery ss	Vascular surgery mips specialty set
G5	Urr reading of 75 or greater	Most recent urr reading of 75 or greater
G6	Esrd patient <6 dialysis/mth	Esrd patient for whom less than six dialysis sessions have been provided in a month
G6001	Echo guidance radiotherapy	Ultrasonic guidance for placement of radiation therapy fields
G6002	Stereoscopic x-ray guidance	Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy
G6003	Radiation treatment delivery	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev
G6004	Radiation treatment delivery	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev
G6005	Radiation treatment delivery	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev
G6006	Radiation treatment delivery	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater
G6007	Radiation treatment delivery	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev
G6008	Radiation treatment delivery	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev
G6009	Radiation treatment delivery	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev
G6010	Radiation treatment delivery	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater
G6011	Radiation treatment delivery	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev
G6012	Radiation treatment delivery	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev
G6013	Radiation treatment delivery	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev
G6014	Radiation treatment delivery	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater
G6015	Radiation tx delivery imrt	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
G6016	Delivery comp imrt	Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session
G6017	Intrafraction track motion	Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment
G6018	Ileoscopy w/stent	Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)
G6019	Colonoscopy lesion removal	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	Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
G6021	Unlisted px small intestine	Unlisted procedure, intestine
G6022	Sigmoidoscopy w/ablate tumr	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	Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)
G6024	Lesion removal colonoscopy	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	Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)
G6027	Anoscopy hra w/spec collect	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	Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)
G6030	Assay of amitriptyline	Amitriptyline
G6031	Assay of benzodiazepines	Benzodiazepines
G6032	Assay of desipramine	Desipramine
G6034	Assay of doxepin	Doxepin
G6035	Assay of gold	Gold
G6036	Assay of imipramine	Assay of imipramine
G6037	Assay of nortiptyline	Nortriptyline
G6038	Assay of salicylate	Salicylate
G6039	Assay of acetaminophen	Acetaminophen
G6040	Assay of ethanol	Alcohol (ethanol); any specimen except breath
G6041	Assay of urine alkaloids	Alkaloids, urine, quantitative
G6042	Assay of amphetamines	Amphetamine or methamphetamine
G6043	Assay of barbiturates	Barbiturates, not elsewhere specified
G6044	Assay of cocaine	Cocaine or metabolite
G6045	Assay of dihydrocodeinone	Dihydrocodeinone
G6046	Assay of dihydromorphinone	Dihydromorphinone
G6047	Assay of dihydrotestosterone	Dihydrotestosterone
G6048	Assay of dimethadione	Dimethadione
G6049	Asssay of epiandrosterone	Epiandrosterone
G6050	Assay of ethchlorvynol	Ethchlorvynol
G6051	Assay of flurazepam	Flurazepam
G6052	Assay of meprobamate	Meprobamate
G6053	Assay of methadone	Methadone
G6054	Assay of methsuximide	Methsuximide
G6055	Assay of nicotine	Nicotine
G6056	Assay of opiates	Opiate(s), drug and metabolites, each procedure
G6057	Assay of phenothiazine	Phenothiazine
G6058	Drug confirmation	Drug confirmation, each procedure
G7	Payment limits do not apply	Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
G8	Monitored anesthesia care	Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
G8126	Pt treat w/antidepress12wks	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	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	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	Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
G8396	Lvef not performed	Left ventricular ejection fraction (lvef) not performed or documented
G8397	Dil macula/fundus exam/w doc	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	Dilated macular or fundus exam not performed
G8399	Pt w/dxa results document	Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed
G8400	Pt w/dxa no results doc	Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given
G8401	Pt inelig osteo screen measu	Clinician documented that patient was not an eligible candidate for screening
G8404	Low extemity neur exam docum	Lower extremity neurological exam performed and documented
G8405	Low extemity neur not perfor	Lower extremity neurological exam not performed
G8406	Pt inelig lower extrem neuro	Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure
G8410	Eval on foot documented	Footwear evaluation performed and documented
G8415	Eval on foot not performed	Footwear evaluation was not performed
G8416	Pt inelig footwear evaluatio	Clinician documented that patient was not an eligible candidate for footwear evaluation measure
G8417	Calc bmi abv up param f/u	Bmi is documented above normal parameters and a follow-up plan is documented
G8418	Calc bmi blw low param f/u	Bmi is documented below normal parameters and a follow-up plan is documented
G8419	Calc bmi out nrm param nof/u	Bmi documented outside normal parameters, no follow-up plan documented, no reason given
G8420	Calc bmi norm parameters	Bmi is documented within normal parameters and no follow-up plan is required
G8421	Bmi not calculated	Bmi not documented and no reason is given
G8422	Pt inelig bmi calculation	Bmi not documented, documentation the patient is not eligible for bmi calculation
G8427	Docrev cur meds by elig clin	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications
G8428	Cur meds not document	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given
G8430	Doc med rsn no medrec	Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an urgent or emergent medical situation)
G8431	Pos clin depres scrn f/u doc	Screening for depression is documented as being positive and a follow-up plan is documented
G8432	Dep scr not doc, rng	Depression screening not documented, reason not given
G8433	Scr for dep not cpt doc rsn	Screening for depression not completed, documented patient or medical reason
G8442	Doc pain as nt perf, not elg	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	Beta-blocker therapy prescribed
G8451	Pt w/abn lvef inelig b-bloc	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	Beta-blocker therapy not prescribed
G8458	Pt inelig geno no antvir tx	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	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	Patient receiving antiviral treatment for hepatitis c during the measurement period
G8464	Pt inelig; lo to no dter rsk	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	High or very high risk of recurrence of prostate cancer
G8473	Ace/arb thxpy rx'd	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed
G8474	Ace/arb not rx'd; doc reas	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	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given
G8476	Bp sys <140 and dias <90	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	Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg
G8478	Bp not performed/doc	Blood pressure measurement not performed or documented, reason not given
G8482	Flu immunize order/admin	Influenza immunization administered or previously received
G8483	Flu imm no admin doc rea	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	Influenza immunization was not administered, reason not given
G8485	Report, diabetes measures	I intend to report the diabetes mellitus (dm) measures group
G8486	Report, prev care measures	I intend to report the preventive care measures group
G8487	Report ckd measures	I intend to report the chronic kidney disease (ckd) measures group
G8489	Cad measures grp	I intend to report the coronary artery disease (cad) measures group
G8490	Ra measures grp	I intend to report the rheumatoid arthritis (ra) measures group
G8491	Hiv/aids measures grp	I intend to report the hiv/aids measures group
G8492	Periop care measures grp	I intend to report the perioperative care measures group
G8493	Back pain measures grp	I intend to report the back pain measures group
G8494	Dm meas qual act perform	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	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	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	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	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	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	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	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	All quality actions for the applicable measures in the back pain measures group have been performed for this patient
G8506	Pt rec ace/arb	Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
G8509	Pos pain assess no f/u doc	Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given
G8510	Scr dep neg, no plan reqd	Screening for depression is documented as negative, a follow-up plan is not required
G8511	Scr dep pos, no plan doc rng	Screening for depression documented as positive, follow-up plan not documented, reason not given
G8530	Auto av fistula recd	Autogenous av fistula received
G8531	Pt inelig; auto av fistula	Clinician documented that patient was not an eligible candidate for autogenous av fistula
G8532	No auto av fistula; no reas	Clinician documented that patient received vascular access other than autogenous av fistula, reason not given
G8535	Eld maltreatment not doc	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	No documentation of an elder maltreatment screen, reason not given
G8539	Doc funct and care plan	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	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	Functional outcome assessment using a standardized tool not documented, reason not given
G8542	Doc funct no deficiencies	Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required
G8543	Cur funct asses; no care pln	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	I intend to report the coronary artery bypass graft (cabg) measures group
G8545	Hepc measures grp	I intend to report the hepatitis c measures group
G8547	Ivd measures grp	I intend to report the ischemic vascular disease (ivd) measures group
G8548	Hf measures grp	I intend to report the heart failure (hf) measures group
G8549	Hepc mg qual act perform	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	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	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	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	Patient has a history of active drainage from the ear within the previous 90 days
G8561	Pt inelig for ref oto eval	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	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	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	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	Verification and documentation of sudden or rapidly progressive hearing loss
G8566	Pt inelig ref oto eval	Patient is not eligible for the referral for otologic evaluation for sudden or rapidly progressive hearing loss measure
G8567	Pt no doc hear loss	Patient does not have verification and documentation of sudden or rapidly progressive hearing loss
G8568	Pt no ref otolo no spec	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	Prolonged postoperative intubation (> 24 hrs) required
G8570	No prol intub req	Prolonged postoperative intubation (> 24 hrs) not required
G8571	Ster wd ifx 30 d postop	Development of deep sternal wound infection/mediastinitis within 30 days postoperatively
G8572	No ster wd ifx	No deep sternal wound infection/mediastinitis
G8573	Stk cabg	Stroke following isolated cabg surgery
G8574	No strk cabg	No stroke following isolated cabg surgery
G8575	Postop ren fail	Developed postoperative renal failure or required dialysis
G8576	No postop ren fail	No postoperative renal failure/dialysis not required
G8577	Reop req bld grft oth	Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
G8578	No reop req bld grft oth	Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
G8579	Antplt med disch	Antiplatelet medication at discharge
G8580	Antplt med contraind	Antiplatelet medication contraindicated
G8581	No antplt med disch	No antiplatelet medication at discharge
G8582	Bblock disch	Beta-blocker at discharge
G8583	Bblock contraind	Beta-blocker contraindicated
G8584	No bblock disch	No beta-blocker at discharge
G8585	Antilipid treat disch	Anti-lipid treatment at discharge
G8586	Antlip disch contra	Anti-lipid treatment contraindicated
G8587	No antlipid treat disch	No anti-lipid treatment at discharge
G8593	Lipid pn results	Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
G8594	No lipid prof perf	Lipid profile not performed, reason not given
G8595	Ldl < 100	Most recent ldl-c < 100 mg/dl
G8597	Ldl >= 100	Most recent ldl-c >= 100 mg/dl
G8598	Asa/antiplat ther used	Aspirin or another antiplatelet therapy used
G8599	No asa/antiplat ther use rng	Aspirin or another antiplatelet therapy not used, reason not given
G8600	Tpa initi w/in 4.5 hr	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	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	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	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	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	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	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	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	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	Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
G8634	Pt no elg phar ther osteo	Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
G8635	No pharm ther osteo rx	Pharmacologic therapy for osteoporosis was not prescribed, reason not given
G8645	Asthma measures grp	I intend to report the asthma measures group
G8646	Asthma mg qual act perform	All quality actions for the applicable measures in the asthma measures group have been performed for this patient
G8647	Rafscrs ki scor >= 0	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	Residual score for the knee impairment successfully calculated and the score was less than zero (< 0)
G8649	Rafscrs ki no scor	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	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	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	Residual score for the hip impairment successfully calculated and the score was less than zero (< 0)
G8653	Rafscrs hi no scor	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	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	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	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	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	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	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	Residual score for the low back impairment successfully calculated and the score was less than zero (< 0)
G8661	Rafscrs lbi no scor	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	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	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	Residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)
G8665	Rafscrs si no scor	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	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	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	Residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)
G8669	Rafscrs	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	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	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	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	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	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	Lvf testing documented as being performed prior to discharge or in the previous 12 months
G8683	Pt not elig for lvf test	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	Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given
G8694	Lvef <=40%	Left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd
G8696	Antithromb thx presc	Antithrombotic therapy prescribed at discharge
G8697	Antithromb no presc doc reas	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	Antithrombotic therapy was not prescribed at discharge, reason not given
G8699	Rehab ordered disch	Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge
G8700	Rehab not indicated disch	Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
G8701	Rehab not ordered	Rehabilitation services were not ordered, reason not otherwise specified
G8702	Antiobiotics 4 hr prior surg	Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
G8703	Antibiotics not prior surg	Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
G8704	Ecg performed	12-lead electrocardiogram (ecg) performed
G8705	Med reas no ecg	Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)
G8706	Pt reas no ecg	Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)
G8707	Ecg not performed	12-lead electrocardiogram (ecg) not performed, reason not given
G8708	Antibiotic not pres	Patient not prescribed antibiotic
G8709	Uri ep compete diag	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	Patient prescribed antibiotic
G8711	Pres antibx on/within 3 day	Prescribed antibiotic on or within 3 days after the episode date
G8712	Not pres antibiotic	Antibiotic not prescribed or dispensed
G8713	Spkt/v great 1.2 kt/v	Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])
G8714	Hemodialysis 3 times week	Hemodialysis treatment performed exactly three times per week for > 90 days
G8717	Less 1.2 kt/v	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	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	Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])
G8721	Pt, pn, hist grade doc	Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
G8722	Med reas pt, pn, not doc	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	Specimen site is other than anatomic location of primary tumor
G8724	Pt, pn, hist grade not doc	Pt category, pn category and histologic grade were not documented in the pathology report, reason not given
G8725	Lipid profile perf doc	Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)
G8726	Doc reas no lipid profile	Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
G8728	Lipid profile not perf	Fasting lipid profile not performed, reason not given
G8730	Pain doc pos and plan	Pain assessment documented as positive using a standardized tool and a follow-up plan is documented
G8731	Pain neg no plan	Pain assessment using a standardized tool is documented as negative, no follow-up plan required
G8732	No doc of pain	No documentation of pain assessment, reason not given
G8733	Doc pos elder mal scrn plan	Elder maltreatment screen documented as positive and a follow-up plan is documented
G8734	Doc neg eld req	Elder maltreatment screen documented as negative, follow-up is not required
G8735	Eld mal scrn pos no plan	Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given
G8736	Ldl-c <100mg/dl	Most current ldl-c <100mg/dl
G8737	Ldl-c >=100mg/dl	Most current ldl-c >=100mg/dl
G8738	Lvef < 40%	Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function
G8739	Lvef >= 40%	Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
G8740	Lvef not perfrmd	Left ventricular ejection fraction (lvef) not performed or assessed, reason not given
G8749	No signs melanoma	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	Smoking status and exposure to second hand smoke in the home not assessed, reason not given
G8752	Sys bp less 140	Most recent systolic blood pressure < 140 mmhg
G8753	Sys bp > or = 140	Most recent systolic blood pressure >= 140 mmhg
G8754	Dias bp less 90	Most recent diastolic blood pressure < 90 mmhg
G8755	Dias bp > or = 90	Most recent diastolic blood pressure >= 90 mmhg
G8756	No bp measure doc	No documentation of blood pressure measurement, reason not given
G8757	Copd mg qual act perform	All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient
G8758	Ibd mg qual act perform	All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient
G8759	Osa mg qual act perform	All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient
G8761	Dementia mg qual act perform	All quality actions for the applicable measures in the dementia measures group have been performed for this patient
G8762	Pd mg qual act perform	All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient
G8763	Hyperten mg qual act perform	All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient
G8764	Car prev mg qual act perform	All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient
G8765	Cataract mg qual act perform	All quality actions for the applicable measures in the cataract measures group have been performed for this patient
G8767	Lipid panel res doc rev	Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
G8768	Doc med reas no lipid profle	Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8769	Lipid profile not perform	Lipid profile not performed, reason not given
G8770	Urine protein test doc rev	Urine protein test result documented and reviewed
G8771	Doc dx ckd	Documentation of diagnosis of chronic kidney disease
G8772	Doc med reas no urine protn	Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)
G8773	No urine protein test	Urine protein test was not performed, reason not given
G8774	Serum creatinine doc rev	Serum creatinine test result documented and reviewed
G8775	Doc med reas no serum crtn	Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8776	No serum creatinine test	Serum creatinine test not performed, reason not given
G8777	Diabetes screen	Diabetes screening test performed
G8778	Doc med reas no diabete scrn	Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8779	No diabetes screen	Diabetes screening test not performed, reason not given
G8780	Counsel diet phys activity	Counseling for diet and physical activity performed
G8781	Doc med reas no counsel diet	Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8782	No counsel diet phys act	Counseling for diet and physical activity not performed, reason not given
G8783	Bp scrn perf rec interval	Normal blood pressure reading documented, follow-up not required
G8784	Pt no elig for bp assess	Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)
G8785	Bp scrn no perf at interval	Blood pressure reading not documented, reason not given
G8797	Specimen site not esophagus	Specimen site other than anatomic location of esophagus
G8798	Specimen site not prostate	Specimen site other than anatomic location of prostate
G8806	Perf ultrsnd to lct preg doc	Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented
G8807	No ta tv ultrasnd	Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has a documented intrauterine pregnancy [iup])
G8808	Ultrasound not perf, rng	Trans-abdominal or trans-vaginal ultrasound not performed, reason not given
G8809	Rh-immunoglobulin order	Rh-immunoglobulin (rhogam) ordered
G8810	Doc reas no rh-immuno	Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)
G8811	No rh-immunoglobulin order	Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
G8815	Doc reas no statin therapy	Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
G8816	Statin med pres at disch	Statin medication prescribed at discharge
G8817	Doc reas no statin med disch	Statin therapy not prescribed at discharge, reason not given
G8818	Pt disch to home by day#7	Patient discharge to home no later than post-operative day #7
G8825	Pt not disch to home day#7	Patient not discharged to home by post-operative day #7
G8826	Pt disch home day #2 evar	Patient discharged to home no later than post-operative day #2 following evar
G8833	Pt not disch home day#2 evar	Patient not discharged to home by post-operative day #2 following evar
G8834	Pt disch home day #2 cea	Patient discharged to home no later than post-operative day #2 following cea
G8838	Not disch home by day #2	Patient not discharged to home by post-operative day #2 following cea
G8839	Sleep apnea assess	Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness
G8840	Doc reas no sleep apnea	Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)
G8841	No sleep apnea assess	Sleep apnea symptoms not assessed, reason not given
G8842	Ahi or rdi initial dx	Apnea hypopnea index (ahi), respiratory disturbance index (rdi) or respiratory event index (rei) documented or measured within 2 months of initial evaluation for suspected obstructive sleep apnea
G8843	Doc reas no ahi or rdi	Documentation of reason(s) for not measuring an apnea hypopnea index (ahi), a respiratory disturbance index (rdi), or a respiratory event index (rei) within 2 months of initial evaluation for suspected obstructive sleep apnea (e.g., medical, neurological, or psychiatric disease that prohibits successful completion of a sleep study, patients for whom a sleep study would present a bigger risk than benefit or would pose an undue burden, dementia, patients who decline ahi/rdi/rei measurement, patients who had a financial reason for not completing testing, test was ordered but not completed, patients decline because their insurance (payer) does not cover the expense))
G8844	No ahi or rdi initial dx	Apnea hypopnea index (ahi), respiratory disturbance index (rdi), or respiratory event index (rei) not documented or measured within 2 months of initial evaluation for suspected obstructive sleep apnea, reason not given
G8845	Pos airway press prescribed	Positive airway pressure therapy prescribed
G8846	Mod or severe osa	Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)
G8848	Mild osa	Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)
G8849	Doc reas no pos air press	Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)
G8850	No pap prescribed	Positive airway pressure therapy not prescribed, reason not given
G8851	Adhere tx assess at lst ann	Adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available, documented)
G8852	Pos air press prescribe	Positive airway pressure therapy was prescribed
G8853	Pos air press not prescribe	Positive airway pressure therapy not prescribed
G8854	Reas no adhere therapy	Documentation of reason(s) for not objectively reporting adherence to evidence-based therapy (e.g., patients who have been diagnosed with a terminal or advanced disease with an expected life span of less than 6 months, patients who decline therapy, patients who do not return for follow-up at least annually, patients unable to access/afford therapy, patient's insurance will not cover therapy)
G8855	Ther not assessed annually	Adherence to therapy was not assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available), reason not given
G8856	Ref for oto eval	Referral to a physician for an otologic evaluation performed
G8857	No elig ref for oto eval	Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)
G8858	Not ref for oto eval	Referral to a physician for an otologic evaluation not performed, reason not given
G8859	Corticosteroids 10mg 60 days	Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
G8860	Corticosteroid 10 mg 60 days	Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
G8861	Dxa ordered for osteo	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
G8862	No corticostrd 10mg 60 days	Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
G8863	No assess bone loss	Patients not assessed for risk of bone loss, reason not given
G8864	Pneumococcal vaccine admin	Pneumococcal vaccine administered or previously received
G8865	Doc med reas no pneumococcal	Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
G8866	Doc pt reas no pneumococcal	Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
G8867	No pneumococcal admin	Pneumococcal vaccine not administered or previously received, reason not given
G8868	1st course antitnf	Patients receiving a first course of anti-tnf therapy
G8869	Doc immune hep b antitnf	Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
G8870	Hepb admin 1st antitnf	Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
G8871	No 1st antitnf	Patient not receiving a first course of anti-tnf therapy
G8872	Intraop image confirm excise	Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8873	Specimen not intraop image	Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
G8874	Tissue not image intraop	Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8875	Breast cancer dx min invsive	Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
G8876	Doc reas no min inv dx	Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)
G8877	No brst cncr dx min invasive	Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given
G8878	Sent lymph node biopsy	Sentinel lymph node biopsy procedure performed
G8879	Node neg inv brst cncr	Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
G8880	Sen lym p node biop not perf	Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)
G8881	Brst cncr stage > t1n0m0	Stage of breast cancer is greater than t1n0m0 or t2n0m0
G8882	No sent lymph node biopsy	Sentinel lymph node biopsy procedure not performed, reason not given
G8883	Rev, comm, track, doc biopsy	Biopsy results reviewed, communicated, tracked and documented
G8884	Doc reas biopsy not review	Clinician documented reason that patient's biopsy results were not reviewed
G8885	No rev, comm, track biopsy	Biopsy results not reviewed, communicated, tracked or documented
G8886	Bp under control	Most recent blood pressure under control
G8887	Doc med reas bp not control	Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8888	Bp not under control	Most recent blood pressure not under control, results documented and reviewed
G8889	No doc bp	No documentation of blood pressure measurement, reason not given
G8890	Ldl-c under control	Most recent ldl-c under control, results documented and reviewed
G8891	Doc med reas no ldl-c contrl	Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8892	Doc med reas no ldl-c test	Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
G8893	Ldl-c not under control	Most recent ldl-c not under control, results documented and reviewed
G8894	Ldl-c not performed	Ldl-c not performed, reason not given
G8895	Antrom prescribe	Oral aspirin or other antithrombotic therapy prescribed
G8896	Doc med reas no antihtrom	Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)
G8897	Antithrom not prescribe	Oral aspirin or other antithrombotic therapy was not prescribed, reason not given
G8898	Copd measures group	I intend to report the chronic obstructive pulmonary disease (copd) measures group
G8899	Inflammatory bowel dis mg	I intend to report the inflammatory bowel disease (ibd) measures group
G8900	Obstructive sleep apnea mg	I intend to report the sleep apnea measures group
G8902	Dementia measures group	I intend to report the dementia measures group
G8903	Parkinson's disease mg	I intend to report the parkinson's disease measures group
G8904	Hypertension mg	I intend to report the hypertension (htn) measures group
G8905	Cardiovascular prevention mg	I intend to report the cardiovascular prevention measures group
G8906	Cataract measures group	I intend to report the cataract measures group
G8907	Pt doc no events on discharg	Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility
G8908	Pt doc w burn prior to d/c	Patient documented to have received a burn prior to discharge
G8909	Pt doc no burn prior to d/c	Patient documented not to have received a burn prior to discharge
G8910	Pt doc to have fall in asc	Patient documented to have experienced a fall within asc
G8911	Pt doc no fall in asc	Patient documented not to have experienced a fall within ambulatory surgical center
G8912	Pt doc with wrong event	Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
G8913	Pt doc no wrong event	Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
G8914	Pt trans to hosp post d/c	Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc
G8915	Pt not trans to hosp at d/c	Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc
G8916	Pt w iv ab given on time	Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time
G8917	Pt w iv ab not given on time	Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time
G8918	Pt w/o preop order iv ab pro	Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis
G8923	Lvef <= 40% or lvsd	Left ventricular ejection fraction (lvef) <= 40% or documentation of moderately or severely depressed left ventricular systolic function
G8924	Spir res doc fev1/fvc<70%	Spirometry results documented (fev1/fvc < 70%)
G8925	Spir fev1/fvc>=60% & no copd	Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms
G8926	Spiro no perf or doc	Spirometry test not performed or documented, reason not given
G8927	Adj chem pres ajcc iii	Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer
G8928	Adj chem not pres rsn spec	Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
G8929	Adj cmo not pres rsn not gvn	Adjuvant chemotherapy not prescribed or previously received, reason not given
G8930	Assess of dep @ initial eval	Assessment of depression severity at the initial evaluation
G8931	Asses of dep not documented	Assessment of depression severity not documented, reason not given
G8932	Suicd rsk assessed init eval	Suicide risk assessed at the initial evaluation
G8933	Suicide risk not assessed	Suicide risk not assessed at the initial evaluation, reason not given
G8934	Lvef <=40% or dep lv sys fcn	Left ventricular ejection fraction (lvef) <=40% or documentation of moderately or severely depressed left ventricular systolic function
G8935	Rx ace or arb therapy	Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
G8936	Pt not eligible ace/arb	Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons)
G8937	No rx ace/arb therapy	Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given
G8938	Bmi doc onl fup nt doc	Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
G8939	Pain as doc positive, no f/u	Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter
G8940	Scr dep pos, no plan done	Screening for depression documented as positive, a follow-up plan not completed, documented reason
G8941	Eld maltreatment doc as pos	Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter
G8942	Doc fcn/care plan w/30 days	Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment
G8943	Ldlc not pres w/i 12 mo prir	Ldl-c result not present or not within 12 months prior
G8944	Ajcc mel cnr stg 0 - iic	Ajcc melanoma cancer stage 0 through iic melanoma
G8946	Mibm but no dx of breast ca	Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)
G8947	1 or more neuropsych	One or more neuropsychiatric symptoms
G8948	No neuropsych symptoms	No neuropsychiatric symptoms
G8949	Doc pt reas on counsel diet	Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)
G8950	Pre-htn or htn doc, f/u indc	Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
G8951	Pre-htn/htn doc, no pt f/u	Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible
G8952	Pre-htn/htn, no f/u, not gvn	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
G8953	Oncology mg qual act perform	All quality actions for the applicable measures in the oncology measures group have been performed for this patient
G8955	Most recent assess vol mgmt	Most recent assessment of adequacy of volume management documented
G8956	Pt rcv hedia outpt dyls fac	Patient receiving maintenance hemodialysis in an outpatient dialysis facility
G8957	Pt no hedia in outpt fac	Patient not receiving maintenance hemodialysis in an outpatient dialysis facility
G8958	Assess vol mgmt not doc	Assessment of adequacy of volume management not documented, reason not given
G8959	Clin tx mdd comm to tx clin	Clinician treating major depressive disorder communicates to clinician treating comorbid condition
G8960	Clin tx mdd not comm	Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given
G8961	Csit lowrisk surg pts preop	Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery
G8962	Csit on pt any reas 30 days	Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery
G8963	Csi per asx pt w/pci 2 yrs	Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years
G8964	Csi any other than pci 2 yr	Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)
G8965	Csit perf on low chd rsk	Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment
G8966	Csit perf sx or high chd rsk	Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment
G8967	Warf or other fda drug presc	Fda approved oral anticoagulant is prescribed
G8968	Doc med not presb	Documentation of medical reason(s) for not prescribing an fda-approved anticoagulant (e.g., present or planned atrial appendage occlusion or ligation or patient being currently enrolled in a clinical trial related to af/atrial flutter treatment)
G8969	Doc pt rsn no presc warf/fda	Documentation of patient reason(s) for not prescribing an oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient preference for not receiving anticoagulation)
G8970	No rsk fac or 1 mod risk te	No risk factors or one moderate risk factor for thromboembolism
G8971	Warfrn or othr antcog no rx	Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
G8972	1>=risk or>= mod risk for te	One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
G8973	Mst rcnt hbb < 10g/dl	Most recent hemoglobin (hgb) level < 10 g/dl
G8974	Hgb not doc rns not gvn	Hemoglobin level measurement not documented, reason not given
G8975	Hgb <10g/dl, med rsn	Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)
G8976	Hgb >= 10 g/dl	Most recent hemoglobin (hgb) level >= 10 g/dl
G8977	Oncology measures grp	I intend to report the oncology measures group
G8978	Mobility current status	Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
G8979	Mobility goal status	Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8980	Mobility d/c status	Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
G8981	Body pos current status	Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
G8982	Body pos goal status	Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8983	Body pos d/c status	Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
G8984	Carry current status	Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
G8985	Carry goal status	Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8986	Carry d/c status	Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
G8987	Self care current status	Self care functional limitation, current status, at therapy episode outset and at reporting intervals
G8988	Self care goal status	Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8989	Self care d/c status	Self care functional limitation, discharge status, at discharge from therapy or to end reporting
G8990	Other pt/ot current status	Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals
G8991	Other pt/ot goal status	Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8992	Other pt/ot d/c status	Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting
G8993	Sub pt/ot current status	Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
G8994	Sub pt/ot goal status	Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8995	Sub pt/ot d/c status	Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
G8996	Swallow current status	Swallowing functional limitation, current status at therapy episode outset and at reporting intervals
G8997	Swallow goal status	Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8998	Swallow d/c status	Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting
G8999	Motor speech current status	Motor speech functional limitation, current status at therapy episode outset and at reporting intervals
G9	Mac for at risk patient	Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
G9001	Mccd, initial rate	Coordinated care fee, initial rate
G9002	Mccd,maintenance rate	Coordinated care fee, maintenance rate
G9003	Mccd, risk adj hi, initial	Coordinated care fee, risk adjusted high, initial
G9004	Mccd, risk adj lo, initial	Coordinated care fee, risk adjusted low, initial
G9005	Mccd, risk adj, maintenance	Coordinated care fee, risk adjusted maintenance
G9006	Mccd, home monitoring	Coordinated care fee, home monitoring
G9007	Mccd, sch team conf	Coordinated care fee, scheduled team conference
G9008	Mccd,phys coor-care ovrsght	Coordinated care fee, physician coordinated care oversight services
G9009	Mccd, risk adj, level 3	Coordinated care fee, risk adjusted maintenance, level 3
G9010	Mccd, risk adj, level 4	Coordinated care fee, risk adjusted maintenance, level 4
G9011	Mccd, risk adj, level 5	Coordinated care fee, risk adjusted maintenance, level 5
G9012	Other specified case mgmt	Other specified case management service not elsewhere classified
G9013	Esrd demo bundle level i	Esrd demo basic bundle level i
G9014	Esrd demo bundle-level ii	Esrd demo expanded bundle including venous access and related services
G9016	Demo-smoking cessation coun	Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]
G9017	Amantadine hcl 100mg oral	Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
G9018	Zanamivir,inhalation pwd 10m	Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)
G9019	Oseltamivir phosphate 75mg	Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)
G9020	Rimantadine hcl 100mg oral	Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
G9033	Amantadine hcl oral brand	Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)
G9034	Zanamivir, inh pwdr, brand	Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)
G9035	Oseltamivir phosp, brand	Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)
G9036	Rimantadine hcl, brand	Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)
G9037	Intrpro req fr rec phys/qhcp	Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified health care professional for the care of the patient (i.e. not for professional education or scheduling) and may include subsequent follow up on the specialist's recommendations; 30 minutes
G9038	Co-management services	Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care planning; condition for which specialist is taking a co-management role; condition expected to last at least 3 months; comprehensive care plan established, implemented, revised or monitored in partnership with co-managing clinicians; ongoing communication and care coordination between co-managing clinicians furnishing care
G9050	Oncology work-up evaluation	Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)
G9051	Oncology tx decision-mgmt	Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)
G9052	Onc surveillance for disease	Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
G9053	Onc expectant management pt	Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
G9054	Onc supervision palliative	Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)
G9055	Onc visit unspecified nos	Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)
G9056	Onc prac mgmt adheres guide	Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)
G9057	Onc pract mgmt differs trial	Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)
G9058	Onc prac mgmt disagree w/gui	Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)
G9059	Onc prac mgmt pt opt alterna	Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)
G9060	Onc prac mgmt dif pt comorb	Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)
G9061	Onc prac cond noadd by guide	Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
G9062	Onc prac guide differs nos	Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)
G9063	Onc dx nsclc stgi no progres	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9064	Onc dx nsclc stg2 no progres	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9065	Onc dx nsclc stg3a no progre	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9066	Onc dx nsclc stg3b-4 metasta	Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9067	Onc dx nsclc dx unknown nos	Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9068	Onc dx sclc/nsclc limited	Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9069	Onc dx sclc/nsclc ext at dx	Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9070	Onc dx sclc/nsclc ext unknwn	Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9071	Onc dx brst stg1-2b hr,nopro	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9072	Onc dx brst stg1-2 noprogres	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i, or stage iia-iib; or t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9073	Onc dx brst stg3-hr, no pro	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9074	Onc dx brst stg3-noprogress	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9075	Onc dx brst metastic/ recur	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9077	Onc dx prostate t1no progres	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t1-t2c and gleason 2-7 and psa < or equal to 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9078	Onc dx prostate t2no progres	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9079	Onc dx prostate t3b-t4noprog	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t3b-t4, any n; any t, n1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9080	Onc dx prostate w/rise psa	Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising psa or failure of psa decline (for use in a medicare-approved demonstration project)
G9083	Onc dx prostate unknwn nos	Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9084	Onc dx colon t1-3,n1-2,no pr	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9085	Onc dx colon t4, n0 w/o prog	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9086	Onc dx colon t1-4 no dx prog	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-4, n1-2, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9087	Onc dx colon metas evid dx	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)
G9088	Onc dx colon metas noevid dx	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive without current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)
G9089	Onc dx colon extent unknown	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9090	Onc dx rectal t1-2 no progr	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-2, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9091	Onc dx rectal t3 n0 no prog	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t3, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9092	Onc dx rectal t1-3,n1-2noprg	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n1-2, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence or metastases (for use in a medicare-approved demonstration project)
G9093	Onc dx rectal t4,n,m0 no prg	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9094	Onc dx rectal m1 w/mets prog	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9095	Onc dx rectal extent unknwn	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9096	Onc dx esophag t1-t3 noprog	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t1-t3, n0-n1 or nx (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9097	Onc dx esophageal t4 no prog	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9098	Onc dx esophageal mets recur	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9099	Onc dx esophageal unknown	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9100	Onc dx gastric no recurrence	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r0 resection (with or without neoadjuvant therapy) with no evidence of disease recurrence, progression, or metastases (for use in a medicare-approved demonstration project)
G9101	Onc dx gastric p r1-r2noprog	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r1 or r2 resection (with or without neoadjuvant therapy) with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9102	Onc dx gastric unresectable	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m0, unresectable with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9103	Onc dx gastric recurrent	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9104	Onc dx gastric unknown nos	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9105	Onc dx pancreatc p r0 res no	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post r0 resection without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9106	Onc dx pancreatc p r1/r2 no	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; post r1 or r2 resection with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9107	Onc dx pancreatic unresectab	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; unresectable at diagnosis, m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9108	Onc dx pancreatic unknwn nos	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9109	Onc dx head/neck t1-t2no prg	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t1-t2 and n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9110	Onc dx head/neck t3-4 noprog	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t3-4 and/or n1-3, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9111	Onc dx head/neck m1 mets rec	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9112	Onc dx head/neck ext unknown	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9113	Onc dx ovarian stg1a-b no pr	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 1) without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9114	Onc dx ovarian stg1a-b or 2	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 2-3); or stage ic (all grades); or stage ii; without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9115	Onc dx ovarian stg3/4 noprog	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage iii-iv; without evidence of progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9116	Onc dx ovarian recurrence	Oncology; disease status; ovarian cancer, limited to epithelial cancer; evidence of disease progression, or recurrence, and/or platinum resistance (for use in a medicare-approved demonstration project)
G9117	Onc dx ovarian unknown nos	Oncology; disease status; ovarian cancer, limited to epithelial cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9123	Onc dx cml chronic phase	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; chronic phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9124	Onc dx cml acceler phase	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; accelerated phase not in hematologic cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9125	Onc dx cml blast phase	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; blast phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9126	Onc dx cml remission	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9128	Onc dx multi myeloma stage i	Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)
G9129	Onc dx mult myeloma stg2 hig	Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)
G9130	Onc dx multi myeloma unknown	Oncology; disease status; limited to multiple myeloma, systemic disease; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9131	Onc dx brst unknown nos	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9132	Onc dx prostate mets no cast	Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-refractory/androgen-independent (e.g., rising psa on anti-androgen therapy or post-orchiectomy); clinical metastases (for use in a medicare-approved demonstration project)
G9133	Onc dx prostate clinical met	Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)
G9134	Onc nhlstg 1-2 no relap no	Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage i, ii at diagnosis, not relapsed, not refractory (for use in a medicare-approved demonstration project)
G9135	Onc dx nhl stg 3-4 not relap	Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage iii, iv, not relapsed, not refractory (for use in a medicare-approved demonstration project)
G9136	Onc dx nhl trans to lg bcell	Oncology; disease status; non-hodgkin's lymphoma, transformed from original cellular diagnosis to a second cellular classification (for use in a medicare-approved demonstration project)
G9137	Onc dx nhl relapse/refractor	Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)
G9138	Onc dx nhl stg unknown	Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)
G9139	Onc dx cml dx status unknown	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; extent of disease unknown, staging in progress, not listed (for use in a medicare-approved demonstration project)
G9140	Frontier extended stay demo	Frontier extended stay clinic demonstration; for a patient stay in a clinic approved for the cms demonstration project; the following measures should be present: the stay must be equal to or greater than 4 hours; weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration; there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer; payment is made on each period up to 4 hours, after the first 4 hours
G9143	Warfarin respon genetic test	Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)
G9147	Outpt iv insulin tx any mea	Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration
G9148	Medical home level 1	National committee for quality assurance - level 1 medical home
G9149	Medical home level ii	National committee for quality assurance - level 2 medical home
G9150	Medical home level iii	National committee for quality assurance - level 3 medical home
G9151	Mapcp demo state	Mapcp demonstration - state provided services
G9152	Mapcp demo community	Mapcp demonstration - community health teams
G9153	Mapcp demo physician	Mapcp demonstration - physician incentive pool
G9156	Evaluation for wheelchair	Evaluation for wheelchair requiring face to face visit with physician
G9157	Transesoph doppl cardiac mon	Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes
G9158	Motor speech d/c status	Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting
G9159	Lang comp current status	Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals
G9160	Lang comp goal status	Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9161	Lang comp d/c status	Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting
G9162	Lang express current status	Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals
G9163	Lang express goal status	Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9164	Lang express d/c status	Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting
G9165	Atten current status	Attention functional limitation, current status at therapy episode outset and at reporting intervals
G9166	Atten goal status	Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9167	Atten d/c status	Attention functional limitation, discharge status at discharge from therapy or to end reporting
G9168	Memory current status	Memory functional limitation, current status at therapy episode outset and at reporting intervals
G9169	Memory goal status	Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9170	Memory d/c status	Memory functional limitation, discharge status at discharge from therapy or to end reporting
G9171	Voice current status	Voice functional limitation, current status at therapy episode outset and at reporting intervals
G9172	Voice goal status	Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9173	Voice d/c status	Voice functional limitation, discharge status at discharge from therapy or to end reporting
G9174	Speech lang current status	Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals
G9175	Speech lang goal status	Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9176	Speech lang d/c status	Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting
G9186	Motor speech goal status	Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9187	Bpci home visit	Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code
G9188	Beta not given no reason	Beta-blocker therapy not prescribed, reason not given
G9189	Beta pres or already taking	Beta-blocker therapy prescribed or currently being taken
G9190	Medical reason for no beta	Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)
G9191	Pt reason for no beta	Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)
G9192	System reason for no beta	Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)
G9193	Doc not eligible for dep med	Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression
G9194	Mdd pt treated for 180d	Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase
G9195	Mdd pt not treated for 180d	Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase
G9196	Med reason for no ceph	Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))
G9197	Order for ceph	Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis
G9198	No order for ceph no reason	Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given
G9199	Doc reason for no vte	Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))
G9200	No reason for no vte	Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
G9201	Vte given upon admission	Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
G9202	Hep c aby pos	Patients with a positive hepatitis c antibody test
G9203	Hep c rna done prior to med	Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
G9204	No reason for no hep c rna	Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
G9205	Hep c antiviral started	Patient starting antiviral treatmentfor hepatitis c during the measurement period
G9206	Hep c therapy started	Patient starting antiviral treatment for hepatitis c during the measurement period
G9207	Hep c genotype prior to med	Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
G9208	No reason for no hep c geno	Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
G9209	Hep c rna 4to12 wk after med	Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment
G9210	No hepc rna after med docrsn	Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)
G9211	No hepc rna after med no rsn	Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given
G9212	Doc of dsm-iv init eval	Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation
G9213	No doc of dsm-iv	Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified
G9214	Cd4 count documented	Cd4+ cell count or cd4+ cell percentage results documented
G9215	No cd4 count no reason	Cd4+ cell count or percentage not documented as performed, reason not given
G9216	No pcp proph at dx no reason	Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given
G9217	No pcp proph low cd4 norsn	Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given
G9218	No pcp prop low at cd4 norsn	Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given
G9219	No oder pjp for med reason	Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)
G9220	No order for pjp for medrsn	Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)
G9221	Pjp proph prescribed	Pneumocystis jiroveci pneumonia prophlaxis prescribed
G9222	Pjp proph ordered low cd4	Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
G9223	Pjp proph ordered cd4 low	Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%
G9224	Medrsn no foot exam	Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)
G9225	Norsn no foot exam	Foot exam was not performed, reason not given
G9226	3 comp foot exam completed	Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)
G9227	Foa doc, care plan not doc	Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter
G9228	Gc chl syp documented	Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)
G9229	Ptrsn no gc chl syp test	Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)
G9230	Norsn for gc chl syp test	Chlamydia, gonorrhea, and syphilis not screened, reason not given
G9231	Doc esrd dia trans preg	Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period
G9232	Ptrsn no comm comorbid	Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)
G9233	Tkr composite	All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
G9234	Tkr intent	I intend to report the total knee replacement measures group
G9235	Gs mg composite	All quality actions for the applicable measures in the general surgery measures group have been performed for this patient
G9236	Op rad mg composite	All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient
G9237	Gs mg intent	I intend to report the general surgery measures group
G9238	Op rad mg intent	I intend to report the optimizing patient exposure to ionizing radiation measures group
G9239	Doc rsn hemod & cath acc	Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)
G9240	Doc pt w cath maint dia	Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated
G9241	Doc pt w out cath maint dia	Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated
G9242	Doc viral load >=200	Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed
G9243	Doc viral load <200	Documentation of viral load less than 200 copies/ml
G9244	Antiviral not ordered	Antiretroviral thereapy not prescribed
G9245	Antiviral ordered	Antiretroviral therapy prescribed
G9246	No med visit in 24mo	Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits
G9247	1 med visit in 24mo	Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits
G9248	No med visit 6mo	Patient did not have a medical visit in the last 6 months
G9249	Med visit w in 6mo	Patient had a medical visit in the last 6 months
G9250	Doc of pain comfort 48hr	Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment
G9251	Doc no pain comfort 48hr	Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment
G9252	Neo detect scrn colo	Adenoma(s) or other neoplasm detected during screening colonoscopy
G9253	No neo detect scrn colo	Adenoma(s) or other neoplasm not detected during screening colonoscopy
G9254	Doc pt dischg >2d	Documentation of patient discharged to home later than post-operative day 2 following cas
G9255	Doc pt dischg <=2d	Documentation of patient discharged to home no later than post operative day 2 following cas
G9256	Doc of pat death after cas	Documentation of patient death following cas
G9257	Doc of pat stroke after cas	Documentation of patient stroke following cas
G9258	Doc of pat stroke after cea	Documentation of patient stroke following cea
G9259	Survive/no stroke post cas	Documentation of patient survival and absence of stroke following cas
G9260	Doc of pat death after cea	Documentation of patient death following cea
G9261	Survive/no stroke post cea	Documentation of patient survival and absence of stroke following cea
G9262	Doc of death post-aaa repair	Documentation of patient death in the hospital following endovascular aaa repair
G9263	Doc of disch post-aaa repair	Documentation of patient discharged alive following endovascular aaa repair
G9264	Doc rsn hemod w/cath >=90d	Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)
G9265	Doc cath >90d for maint dia	Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access
G9266	Norsn pt cath >=90d	Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access
G9267	Doc comp or mort w in 30d	Documentation of patient with one or more complications or mortality within 30 days
G9268	Doc comp or mort w in 90d	Documentation of patient with one or more complications within 90 days
G9269	Doc no comp or mort w in 30d	Documentation of patient without one or more complications and without mortality within 30 days
G9270	Doc no comp or mort w in 90d	Documentation of patient without one or more complications within 90 days
G9271	Ldl under 100	Ldl value < 100
G9272	Ldl 100 and over	Ldl value >= 100
G9273	Sys<140 and dia<90	Blood pressure has a systolic value of < 140 and a diastolic value of < 90
G9274	Bp out of nrml limits	Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
G9275	Doc of non tobacco user	Documentation that patient is a current non-tobacco user
G9276	Doc of tobacco user	Documentation that patient is a current tobacco user
G9277	Doc daily aspirin or contra	Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)
G9278	Doc no daily aspirin	Documentation that the patient is not on daily aspirin or anti-platelet regimen
G9279	Pne scrn done doc vac done	Pneumococcal screening performed and documentation of vaccination received prior to discharge
G9280	Pne not given norsn	Pneumococcal vaccination not administered prior to discharge, reason not specified
G9281	Pne scrn done doc not ind	Screening performed and documentation that vaccination not indicated/patient refusal
G9282	Doc medrsn no histo type	Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)
G9283	Hist type doc on report	Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
G9284	No hist type doc on report	Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
G9285	Site not small cell lung ca	Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer
G9286	Antibio rx w in 10d of sympt	Antibiotic regimen prescribed within 10 days after onset of symptoms
G9287	No antibio w in 10d of sympt	Antibiotic regimen not prescribed within 10 days after onset of symptoms
G9288	Doc medrsn no hist type rpt	Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)
G9289	Doc type nsm lung ca	Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
G9290	No doc type nsm lung ca	Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
G9291	Not nsm lung ca	Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos
G9292	Medrsn no pt category	Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)
G9293	No pt category on report	Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9294	Pt cat and thck on report	Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9295	Non cutaneous loc	Specimen site other than anatomic cutaneous location
G9296	Doc share dec prior proc	Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure
G9297	No doc share dec prior proc	Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given
G9298	Eval risk vte card 30d prior	Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)
G9299	No eval risk vte card prior	Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)
G9300	Doc medrsn no compl antibio	Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)
G9301	Doc compl inf antibio	Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
G9302	Norsn incomp inf antibio	Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given
G9303	Norsn no pros info op rpt	Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given
G9304	Pros info op rpt	Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant
G9305	No interv req for leak	Intervention for presence of leak of endoluminal contents through an anastomosis not required
G9306	Interv req for leak	Intervention for presence of leak of endoluminal contents through an anastomosis required
G9307	No ret for surg w in 30d	No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
G9308	Unpl ret or w/compl w/in 30d	Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
G9309	No unplnd hosp readm in 30d	No unplanned hospital readmission within 30 days of principal procedure
G9310	Unplnd hosp readm in 30d	Unplanned hospital readmission within 30 days of principal procedure
G9311	No surg site infection	No surgical site infection
G9312	Surgical site infection	Surgical site infection
G9313	Amoxic not presc as 1st line	Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason
G9314	Norsn not first line amox	Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given
G9315	Amox w/wo clav rx	Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis
G9316	Doc comm risk calc	Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family
G9317	No doc comm risk calc	Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed
G9318	Image std nomenclature	Imaging study named according to standardized nomenclature
G9319	Image not std nomenclature	Imaging study not named according to standardized nomenclature, reason not given
G9320	Medrsn no std nomenclature	Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9321	Doc count of ct in 12mo	Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study
G9322	No doc count of ct in 12mo	Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given
G9323	Mdrsn no doc cnt of ct	Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9324	Not all data norsn	All necessary data elements not included, reason not given
G9325	Medrsn no ct rpt to reg	Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9326	Ct done no rad ds index, nrg	Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given
G9327	Ct done rad ds index	Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements
G9328	Medrsn no dicom format doc	Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9329	Norsn no dicom format doc	Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given
G9340	Dicom format doc on rpt	Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study
G9341	Srch for ct w in 12 mos	Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed
G9342	No srch for ct in 12mo norsn	Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given
G9343	Medrsn no dicom srch	Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9344	Sysrsn no dicom srch	Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)
G9345	Follow up pulm nod	Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors
G9346	No follow up pulm nod	Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
G9347	No follow up pulm nod norsn	Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given
G9348	Doc rsn for ord ct scan	Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons
G9349	Ct within 28 days	Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
G9350	No doc sinus ct 28d or dx	Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis
G9351	Doc >1 sinus ct w 90d dx	More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis
G9352	Not >1 sinus ct w 90d dx	More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given
G9353	Medrsn >1 sinus ct w 90d dx	More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)
G9354	1 or no ct sinus w/in 90d dx	One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis
G9355	No early ind/delivery	Elective delivery (without medical indication) by cesarean birth or induction of labor not performed (<39 weeks of gestation)
G9356	Early ind/delivery	Elective delivery (without medical indication) by cesarean birth or induction of labor performed (<39 weeks of gestation)
G9357	Pp eval/edu perf	Post-partum screenings, evaluations and education performed
G9358	Pp eval/edu not perf	Post-partum screenings, evaluations and education not performed
G9359	Neg mgd pos tb notact	Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier
G9360	No doc of neg or man pos tb	No documentation of negative or managed positive tb screen
G9361	Doc rsn elect c-sec/induct	Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]
G9362	Mac or pnb w/o genanes >60m	Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record
G9363	Mac or pnb w/o genanes <60m	Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record
G9364	Sinus caus bac inx	Sinusitis caused by, or presumed to be caused by, bacterial infection
G9365	1high risk med ord	One high-risk medication ordered
G9366	1high risk no ord	One high-risk medication not ordered
G9367	>= 2 same hi-rsk med ord	At least two orders for high-risk medications from the same drug class
G9368	>= 2 same hi-rsk med not ord	At least two orders for high-risk medications from the same drug class not ordered
G9369	Fill 2 rx antipsych	Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater
G9370	Not fill 2 rx antipsych	Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater
G9376	Contd ret attach at 6mth f/u	Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery
G9377	No ret attach after 6mt	Patient did not have the retina attached after 6 months following only one surgery
G9378	Contd ret attach f/u vis	Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)
G9379	No acheive flat ret 6mth	Patient did not achieve flat retinas six months post surgery
G9380	Off assis eol iss	Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period
G9381	Doc med reas no offer eol	Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period
G9382	No off assis eol	Patient not offered assistance with end of life issues or existing end of life plan was not reviewed or updated during the measurement period
G9383	Recd scrn hcv infec	Patient received screening for hcv infection within the 12 month reporting period
G9384	Doc med rsn no hcv scrn	Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)
G9385	Doc pt reas not rec hcv srn	Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)
G9386	Scrn hcv infec not recd	Screening for hcv infection not received within the 12 month reporting period, reason not given
G9389	Unpln rup post cap	Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9390	No unpln rup post cap	No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9391	Achv refrac +1d	Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
G9392	Not achv refrac +1d	Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
G9393	Ini phq9 >9 remiss <5	Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five
G9394	Dx bipol, death, nhres, hosp	Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period
G9395	Ini phq9 >9 no remiss >=5	Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five
G9396	Ini phq9 >9 not assess	Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)
G9399	Doc disc tx choices	Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment
G9400	Doc reas no disc tx opt	Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons
G9401	No disc tx choices	No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment
G9402	Recd f/u w/in 30d disch	Patient received follow-up within 30 days after discharge
G9403	Doc reas no 30 day f/u	Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)
G9404	No 30 day f/u	Patient did not receive follow-up within 30 days after discharge
G9405	Recd f/u w/in 7d dc	Patient received follow-up within 7 days after discharge
G9406	Doc reas no 7d f/u	Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)
G9407	No 7d f/u	Patient did not receive follow-up within 7 days after discharge
G9408	Card tamp w/in 30d	Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
G9409	No card tamp e/in 30d	Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days
G9410	Admit w/in 180d req remov	Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9411	No admit w/in 180d req remov	Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9412	Admit w/in 180d req surg rev	Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9413	No admit req surg rev	Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9414	1dose menig vac btwn 11 & 13	Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays
G9415	No 1dose meni vac btwn 11&13	Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays
G9416	Pt 1 tdap betw 10-13 yrs	Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
G9417	Pt not 1 tdap betw 10-13 yrs	Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
G9418	Lungcx bx rpt docs class	Primary non-small cell lung cancer lung biopsy and cytology specimen report documents classification into specific histologic type following iaslc guidance or classified as nsclc-nos with an explanation
G9419	Med reas not incl histo type	Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g. specimen insufficient or non-diagnostic, specimen does not contain cancer, or other documented medical reasons)
G9420	Spec site no lung	Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer
G9421	Lung cx bx rpt no doc class	Primary non-small cell lung cancer lung biopsy and cytology specimen report does not document classification into specific histologic type or histologic type does not follow iaslc guidance or is classified as nsclc-nos but without an explanation
G9422	Rpt doc class histo type	Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma and not nsclc-nos)
G9423	Med reas rpt no histo type	Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]
G9424	Site no lung or lung cx	Specimen site other than anatomic location of lung, or classified as nsclc-nos
G9425	Spec rpt no doc class histo	Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma)
G9426	Impr med time edarr pain med	Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients
G9427	No impro med time pain med	Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients
G9428	Patho rpt incl pt ctg	Pathology report includes the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
G9429	Doc med rsn no pt cat	Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons)
G9430	Spec site no cutaneous	Specimen site other than anatomic cutaneous location
G9431	Patho rpt no pt ctg	Pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
G9432	Asth controlled	Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented
G9433	Death, nhres, hospice	Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period
G9434	Asth not controlled	Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given
G9435	Asp presc disch	Aspirin prescribed at discharge
G9436	Asp not presc doc reas	Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
G9437	Asp not presc disch	Aspirin not prescribed at discharge
G9438	P2y inhib presc	P2y inhibitor prescribed at discharge
G9439	P2y inhib not presc doc reas	P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
G9440	P2y inhib not presc	P2y inhibitor not prescribed at discharge
G9441	Statin presc disch	Statin prescribed at discharge
G9442	Statin not presc doc reas	Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)
G9443	Statin not presc disch	Statin not prescribed at discharge
G9448	Born 1945-1965	Patients who were born in the years 1945 to 1965
G9449	Hx bld transf b/f 1992	History of receiving blood transfusions prior to 1992
G9450	Hx injec drug use	History of injection drug use
G9451	1x scrn hcv infect	Patient received one-time screening for hcv infection
G9452	Doc med reas no hcv test	Documentation of medical reason(s) for not receiving hcv antibody test due to limited life expectancy
G9453	Pt reas no hcv infect	Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)
G9454	No scr hcv inf 12 mth rp	One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given
G9455	Abd imag w/us, ct or mri	Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc
G9456	Doc med pt reas no hcc scrn	Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)
G9457	Pt no abd img no doc rsn	Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period
G9458	Tob user recd cess interv	Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user
G9459	Tob non-user	Currently a tobacco non-user
G9460	No tob assess or cess inter	Tobacco assessment or tobacco cessation intervention not performed, reason not given
G9463	Sinusitis intent	I intend to report the sinusitis measures group
G9464	Sinusitis comp	All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient
G9465	Aoe intent	I intend to report the acute otitis externa (aoe) measures group
G9466	Aoe comp	All quality actions for the applicable measures in the aoe measures group have been performed for this patient
G9467	Recd cortico >=10mg/day >60d	Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months
G9468	No recd cortico>=10mg/d >60d	Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
G9469	Rec cortico>90d or 1rx 900mg	Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills
G9470	No rec cortico>60d 1rx 600mg	Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
G9471	W/in 2yr dxa not order	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented
G9472	No dxa no med hx no rv sx	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
G9473	Chap services at hospice	Services performed by chaplain in the hospice setting, each 15 minutes
G9474	Diet counsel at hospice	Services performed by dietary counselor in the hospice setting, each 15 minutes
G9475	Other counselor at hospice	Services performed by other counselor in the hospice setting, each 15 minutes
G9476	Volun service at hospice	Services performed by volunteer in the hospice setting, each 15 minutes
G9477	Care coord at hospice	Services performed by care coordinator in the hospice setting, each 15 minutes
G9478	Othe therapist at hospice	Services performed by other qualified therapist in the hospice setting, each 15 minutes
G9479	Pharmacist at hospice	Services performed by qualified pharmacist in the hospice setting, each 15 minutes
G9480	Admission to mccm	Admission to medicare care choice model program (mccm)
G9481	Remote e/m new pt 10mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9482	Remote e/m new pt 20mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9483	Remote e/m new pt 30mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9484	Remote e/m new pt 45mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9485	Remote e/m new pt 60mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9486	Remote e/m est. pt 10mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9487	Remote e/m est. pt 15mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9488	Remote e/m est. pt 25mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9489	Remote e/m est. pt 40mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9490	Cmmi mod home visit	Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code
G9496	Doc rsn no adeno/neopl detec	Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
G9497	Rec inst no smoke day surg	Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery
G9498	Abx reg prescribed	Antibiotic regimen prescribed
G9499	No start/rec antvir tx hep c	Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period
G9500	Rad expos ind/exp tm doc	Radiation exposure indices documented in final report for procedure using fluoroscopy
G9501	Rad expos ind/exp tm no doc	Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given
G9502	Med reas no perf foot exam	Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
G9503	Pt tk tams hcl	Patient taking tamsulosin hydrochloride
G9504	Doc rsn hep b stat not asses	Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
G9505	Abx pres w/in 10 dys of symp	Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
G9506	Bio imm resp mod presc	Biologic immune response modifier prescribed
G9507	Doc reas on statin or contra	Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
G9508	Doc pt not on statin	Documentation that the patient is not on a statin medication
G9509	Adit mdd dys rem 12 mnths	Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
G9510	Remis12m not phq-9 score <5	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5
G9511	Idx evt dte phq>9 doc 12 mo	Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
G9512	Indiv pdc > 0.8	Individual had a pdc of 0.8 or greater
G9513	Indiv pdc not > 0.8	Individual did not have a pdc of 0.8 or greater
G9514	Req ret or w/in 90d of surg	Patient required a return to the operating room within 90 days of surgery
G9515	No reas, no ret or w/in 90d	Patient did not require a return to the operating room within 90 days of surgery
G9516	Impr vis acuit w/in 90d	Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
G9517	No impr vis acuit w/in 90d	Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
G9518	Doc active inj drug use	Documentation of active injection drug use
G9519	Final ref +/- 1.0 w/in 90d	Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
G9520	Refract not +/- 1.0 w/in 90d	Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
G9521	Er and ip hosp <2 in 12 mos	Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
G9522	Er/ip hosp =/>2 in 12 mos	Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
G9523	D/c hemo or perit dialysis	Patient discontinued from hemodialysis or peritoneal dialysis
G9524	Refer to hospice	Patient was referred to hospice care
G9525	Doc pt reas no hospice refer	Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
G9526	No reason, no refer hospice	Patient was not referred to hospice care, reason not given
G9529	Minor blunt trauma w/head ct	Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
G9530	Pt mbht hd ct ord ec prov	Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider
G9531	Pt doc	Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar
G9532	Pt hd ct ord	Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
G9533	Indic for head ct not valid	Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
G9534	Adv brain image not ordered	Advanced brain imaging (cta, ct, mra or mri) was not ordered
G9535	Normal neuro exam	Patients with a normal neurological examination
G9536	Doc med reas adv brain image	Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
G9537	Img hd clin trial	Imaging needed as part of a clinical trial; or other clinician ordered the study
G9538	Adv brain image ordered	Advanced brain imaging (cta, ct, mra or mri) was ordered
G9539	Intent pot remv time placemt	Intent for potential removal at time of placement
G9540	Pt alive 3 mos post proc	Patient alive 3 months post procedure
G9541	Filter rem 3 mon plmt	Filter removed within 3 months of placement
G9542	Doc reass appr remo filt 3ms	Documented re-assessment for the appropriateness of filter removal within 3 months of placement
G9543	Doc 2x re-assess filt remov	Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
G9544	No filt remov w/in 3mos plcm	Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
G9547	Cys ren les or adren	Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols
G9548	No f/u rec image study	Final reports for imaging studies stating no follow-up imaging is recommended
G9549	Doc med rsn for f/u imag	Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))
G9550	Imag rec	Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up
G9551	Imag no les	Final reports for imaging studies without an incidentally found lesion noted
G9552	Inc thyr node <1.0 in rpt	Incidental thyroid nodule < 1.0 cm noted in report
G9553	Prior thyroid dise dx	Prior thyroid disease diagnosis
G9554	Ct/cta/mri/a chst foll rec	Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended
G9555	Doc med rsn for follup image	Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))
G9556	Ct/cta/mri/a no follup imag	Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging not recommended
G9557	Ct/cta/mri/a no thyr <1.0cm	Final reports for ct, cta, mri or mra studies of the chest or neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found
G9558	Tx beta-lactam abx therapy	Patient treated with a beta-lactam antibiotic as definitive therapy
G9559	Doc med reas no abx therapy	Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)
G9560	No beta-lactam abx ther, rng	Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given
G9561	Presc opiates >6 wks	Patients prescribed opiates for longer than six weeks
G9562	Foll-up eval q3mo opiod tx	Patients who had a follow-up evaluation conducted at least every three months during opioid therapy
G9563	No f/u eval q3mo opiod tx	Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy
G9572	Phq-scr >9 doc in 12m time	Index date phq-score greater than 9 documented during the twelve month denominator identification period
G9573	Adl pt md or dys rem 6 mon	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five
G9574	Adl pt md dys no rem 6 mon	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five
G9577	Presc opiates >6 wks	Patients prescribed opiates for longer than six weeks
G9578	Doc opioid tx 1x during ther	Documentation of signed opioid treatment agreement at least once during opioid therapy
G9579	No doc opioid tx 1x at ther	No documentation of signed an opioid treatment agreement at least once during opioid therapy
G9580	Door to punc time <2hrs	Door to puncture time of 90 minutes or less
G9581	Md doc, door to punc tm >2hr	Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)
G9582	Door to punc time >2hr, nrg	Door to puncture time of greater than 90 minutes, no reason given
G9583	Presc opiates >6 wks	Patients prescribed opiates for longer than six weeks
G9584	Eval opioid use instr/pt int	Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy
G9585	No eval opi use instr/intv	Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy
G9593	Low pecarn ped head trauma	Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules
G9594	Pt mbht hd ct ord ec prov	Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider
G9595	Doc shnt/tum/coag	Patient has documentation of ventricular shunt, brain tumor, or coagulopathy
G9596	Ped pt hd ct ord	Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
G9597	No low pecarn ped head traum	Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules
G9598	Aor ane 5.5-5.9 cm max diam	Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct
G9599	Aor ane >=6.0 cm max diam	Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct
G9600	Symp aaa urgent repair	Symptomatic aaas that required urgent/emergent (non-elective) repair
G9601	Pt dchg home post op day 7	Patient discharge to home no later than post-operative day #7
G9602	Pt no dchg home postop day 7	Patient not discharged to home by post-operative day #7
G9603	Pt surv improv bsline tx	Patient survey score improved from baseline following treatment
G9604	Pt surv results not avail	Patient survey results not available
G9605	Surv score no improv w/tx	Patient survey score did not improve from baseline following treatment
G9606	Intraop cyst eval trac inj	Intraoperative cystoscopy performed to evaluate for lower tract injury
G9607	Doc med rsn not perf cystosc	Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death
G9608	Intraop cyst eval not done	Intraoperative cystoscopy not performed to evaluate for lower tract injury
G9609	Doc order anti-plat	Documentation of an order for anti-platelet agents
G9610	Doc md rsn no antipla	Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents
G9611	No doc order anti-plat rng	Order for anti-platelet agents was not documented in the patient's record, reason not given
G9612	Phodoc 2 mr cec lndmk	Photodocumentation of two or more cecal landmarks to establish a complete examination
G9613	Doc post surg anatomy	Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)
G9614	Photodoc < 2 cec lndmk	Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination
G9615	Pre-op asst doc	Preoperative assessment documented
G9616	Doc rsn no preop assmt	Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)
G9617	Pre-op asst not doc, rng	Preoperative assessment not documented, reason not given
G9618	Doc scr uter mal or us/samp	Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind
G9619	Doc rsn no scr uter malig	Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)
G9620	No scr utr malig/us/samp rng	Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given
G9621	Scr unheal etoh w/counsel	Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling
G9622	No unheal etoh user	Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method
G9623	Doc med rsn no scr etoh use	Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)
G9624	Pt not scrn or no counseling	Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user
G9625	Pt bl srg 30 day pst srg	Patient sustained bladder injury at the time of surgery or discovered subsequently up to 30 days post-surgery
G9626	Med rsn no rpt bladder inj	Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury)
G9627	Pt no bl srg 30 day pst srg	Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 30 days post-surgery
G9628	Pt bwli srg 30 day pst srg	Patient sustained bowel injury at the time of surgery or discovered subsequently up to 30 days post-surgery
G9629	Med rsn no rpt bowel inj	Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury)
G9630	Pt no bwli srg 30 day srg	Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery
G9631	Pt ui srg 30 day pst srg	Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
G9632	Med rsn for no rpt uret inj	Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury)
G9633	Pt no ui srg 30 day pst srg	Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery
G9634	Qual life tool 2x same/impr	Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved
G9635	No doc rsn do qual life assm	Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)
G9636	No life asst 2x same/decr	Health-related quality of life not assessed with tool during at least two visits or quality of life score declined
G9637	Doc >1 dose reduc tech	Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)
G9638	No doc >1 dose reduc tech	Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)
G9639	Amp no reqd in48h ieler proc	Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure
G9640	Doc plan hybrid/stage proc	Documentation of planned hybrid or staged procedure
G9641	Amp reqd w/in 48h ieler proc	Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure
G9642	Current smoker	Current smoker (e.g., cigarette, cigar, pipe, e-cigarette or marijuana)
G9643	Elective surgery	Elective surgery
G9644	No smok b/4 anes day of surg	Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure
G9645	Had smoke b/4 anes day surg	Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure
G9646	Pt w/90d mrs 0-2	Patients with 90 day mrs score of 0 to 2
G9647	No mrs score in 90d followup	Patients in whom mrs score could not be obtained at 90 day follow-up
G9648	Pt w/90d mrs >2	Patients with 90 day mrs score greater than 2
G9649	Psor as doc spc bm	Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))
G9650	Doc pt no ther chg or contra	Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
G9651	Psor as doc no spc bm	Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) or psoriasis assessment tool not documented
G9652	Pt tx sys bio med psori 6mth	Patient has been treated with a systemic or biologic medication for psoriasis for at least six months
G9653	Pt no tx sys bio rx 6 mths	Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months
G9654	Mon anesth care	Monitored anesthesia care (mac)
G9655	Toc tool incl key elem	A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used
G9656	Pt trans from anest to pacu	Patient transferred directly from anesthetizing location to pacu or other non-icu location
G9657	Toc dur aneth to icu	Transfer of care during an anesthetic or to the intensive care unit
G9658	Toc tool incl elem not used	A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used
G9659	>=86y no hx colo ca/rsn scop	Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits
G9660	Doc med rsn scope pt >= 86y	Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits)
G9661	Pt >= 86 w/ hi risk	Patients greater than or equal to 86 years of age who received a colonoscopy for an assessment of signs/symptoms of gi tract illness, and/or because the patient meets high risk criteria, and/or to follow-up on previously diagnosed advanced lesions
G9662	Prior dx/active clin ascvd	Previously diagnosed or have a diagnosis of clinical ascvd, including ascvd procedure
G9663	Fast/dir ldl >= 190 mg/dl	Any ldl-c laboratory result >= 190 mg/dl
G9664	Taking statin or rec'd order	Patients who are currently statin therapy users or received an order (prescription) for statin therapy
G9665	No statin/no order statin	Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy
G9666	Fas/dir ldl 70-189mg/dl mst	Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl
G9667	Doc med rsn no stat tx/presc	Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)
G9669	Intend rpt mult chr msr grp	I intend to report the multiple chronic conditions measures group
G9670	Qty act mcc mg perf	All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient
G9671	Intend rpt dia retin msr grp	I intend to report the diabetic retinopathy measures group
G9672	Qty act diab retin mg perf	All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient
G9673	Intend rpt card prev msr grp	I intend to report the cardiovascular prevention measures group
G9674	Pt w/clin ascvd dx	Patients with clinical ascvd diagnosis
G9675	Pt w/fast/dir lab ldl-c >190	Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
G9676	40-75y w/type 1/2 w/ldl-c rs	Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period
G9677	Qty act card prev mg perf	All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient
G9678	Oncology care model service	Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement
G9679	Acute care pneumonia	This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary
G9680	Acute care congestive heart	This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary
G9681	Acute care chronic obstruct	This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary
G9682	Acute care skin infection	This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary
G9683	Acute fluid/electro disorder	Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project
G9684	Acute care urinary tract inf	This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary
G9685	Acute nursing facility care	Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project
G9686	Nursing facility conference	Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team
G9687	Hospice anytime msmt per	Hospice services provided to patient any time during the measurement period
G9688	Pt w/hosp anytime msmt per	Patients using hospice services any time during the measurement period
G9689	Inpt elect carotid intervent	Patient admitted for performance of elective carotid intervention
G9690	Pt in hos	Patient receiving hospice services any time during the measurement period
G9691	Pt hosp dur msmt period	Patient had hospice services any time during the measurement period
G9692	Hosp recd by pt dur msmt per	Hospice services received by patient any time during the measurement period
G9693	Pt use hosp during msmt per	Patient use of hospice services any time during the measurement period
G9694	Hosp srv used pt in msmt per	Hospice services utilized by patient any time during the measurement period
G9695	Long act inhal bronchdil pre	Long-acting inhaled bronchodilator prescribed
G9696	Med rsn no presc bronchdil	Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects)
G9697	Pt rsn no presc bronchdil	Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator
G9698	Sys rsn no presc bronchdil	Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., cost of treatment or lack of insurance)
G9699	Long inhal bronchdil no pres	Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified
G9700	Pt is w/hosp during msmt per	Patients who use hospice services any time during the measurement period
G9701	Child anbx 30 prior dx estab	Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established
G9702	Pt use hosp during msmt per	Patients who use hospice services any time during the measurement period
G9703	Anbx 30 prior to episode	Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
G9704	Ajcc br ca stg i: t1 mic/t1a	Ajcc breast cancer stage i: t1 mic or t1a documented
G9705	Ajcc br ca stg ib	Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented
G9706	Low recur prost ca	Low (or very low) risk of recurrence, prostate cancer
G9707	Pt had hosp dur msmt per	Patient received hospice services any time during the measurement period
G9708	Bilat mast/hx bi /unilat mas	Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
G9709	Hosp srv used pt in msmt per	Hospice services used by patient any time during the measurement period
G9710	Pt prov hosp srv msmt per	Patient was provided hospice services any time during the measurement period
G9711	Pt hx tot col or colon ca	Patients with a diagnosis or past history of total colectomy or colorectal cancer
G9712	Doc med rsn presc anbx	Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/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/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis
G9713	Pt use hosp during msmt per	Patients who use hospice services any time during the measurement period
G9714	Pt is w/hosp during msmt per	Patient is using hospice services any time during the measurement period
G9715	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9716	Bmi doc onl fup not cmpltd	Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
G9717	Doc pt dx bipol	Documentation stating the patient has had a diagnosis of bipolar disorder
G9718	Hospice anytime msmt per	Hospice services for patient provided any time during the measurement period
G9719	Pt not ambul/immob/wc	Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9720	Hospice anytime msmt per	Hospice services for patient occurred any time during the measurement period
G9721	Pt not ambul/immob/wc	Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9722	Doc hx renal fail or cr+ >=4	Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher
G9723	Hosp recd by pt dur msmt per	Hospice services for patient received any time during the measurement period
G9724	Pt w/doc use anticoag mst yr	Patients who had documentation of use of anticoagulant medications overlapping the measurement year
G9725	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9726	Refused to participate	Patient refused to participate
G9727	Pt unable cmplt lepf prom	Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9728	Refused to participate	Patient refused to participate
G9729	Pt unbl cmplt lepf prom	Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9730	Refused to participate	Patient refused to participate
G9731	Pt unbl cmplt lepf prom	Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9732	Refused to participate	Patient refused to participate
G9733	Pt unbl cmplt lb fs prom	Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9734	Refused to participate	Patient refused to participate
G9735	Pt unbl cmplt shld fs prom	Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9736	Refused to participate	Patient refused to participate
G9737	Pt unbl cmplt ewh fs prom	Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9738	Refused to participate	Patient refused to participate
G9739	Pt unbl cmplt go fs prom	Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9740	Hosp srv to pt dur msmt per	Hospice services given to patient any time during the measurement period
G9741	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9742	Psych sympt assessed	Psychiatric symptoms assessed
G9743	Psych symp not assessed, rns	Psychiatric symptoms not assessed, reason not otherwise specified
G9744	Pt not eli d/t act dig htn	Patient not eligible due to active diagnosis of hypertension
G9745	Doc rsn no hbp scrn or f/u	Documented reason for not screening or recommending a follow-up for high blood pressure
G9746	Mit sten, valve or trans af	Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9747	Pall dialysis with catheter	Patient is undergoing palliative dialysis with a catheter
G9748	App transpl lvg kidney donor	Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9749	Pall dialysis with catheter	Patient is undergoing palliative dialysis with a catheter
G9750	App transpl lvg kidney donor	Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9751	Pt died w/in 24 mos rpt time	Patient died at any time during the 24-month measurement period
G9752	Urgent surgery	Emergency surgery
G9753	Doc no dicom, ct other fac	Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)
G9754	Incid pulm nodule	A finding of an incidental pulmonary nodule
G9755	Doc med rsn no fllw up	Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection)
G9756	Surg proc w/silicone oil	Surgical procedures that included the use of silicone oil
G9757	Surg proc w/silicone oil	Surgical procedures that included the use of silicone oil
G9758	Pt in hos	Patient in hospice at any time during the measurement period
G9759	Hx preop post cap rup	History of preoperative posterior capsule rupture
G9760	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9761	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9762	Pt had >= 2-3 hpv vaccines	Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9763	Pt not have 2-3 hpv vaccines	Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9764	Pt treatd w/oral syst or bio	Patient has been treated with a systemic medication for psoriasis vulgaris
G9765	Doc pat declined therapy	Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
G9766	Cva stroke dx tx transf fac	Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment
G9767	Hosp new dx cva consid evst	Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment
G9768	Pt w/hosp anytime msmt per	Patients who utilize hospice services any time during the measurement period
G9769	Bn den 2yr/got ost med/ther	Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months
G9770	Perip nerve block	Peripheral nerve block (pnb)
G9771	Anes end, 1 temp >35.5(95.9)	At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time
G9772	Doc med rsn no temp >= 35.5	Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)
G9773	1 bod temp >=35.5	At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time, reason not given
G9774	Pt had hyst	Patients who have had a hysterectomy
G9775	Recd 2 anti-emet pre/intraop	Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9776	Doc med rsn no proph antiem	Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9777	Pt no antiemet pre/intraop	Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9778	Pts dx w/pregn	Patients who have a diagnosis of pregnancy at any time during the measurement period
G9779	Pts breastfeeding	Patients who are breastfeeding at any time during the performance period
G9780	Pts dx w/rhabdomyolysis	Patients who have a diagnosis of rhabdomyolysis at any time during the performance period
G9781	Doc rsn no statin	Documentation of medical reason(s) for not currently being a statin therapy user or receiving an order (prescription) for statin therapy (e.g., patients with statin-associated muscle symptoms or an allergy to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease [esrd], or other medical reasons)
G9782	Hx dx fam/pure hypercholes	History of or active diagnosis of familial hypercholesterolemia
G9783	Doc dx dm, fast <70, no stat	Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy
G9784	Path/derm prov 2nd biop opin	Pathologists/dermatopathologists providing a second opinion on a biopsy
G9785	Path report sent	Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9786	Path report not sent	Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9787	Pt alive	Patient alive as of the last day of the measurement year
G9788	Most rct bp	Most recent bp is less than or equal to 140/90 mm hg
G9789	Record bp ip, er, urg/self	Blood pressure recorded during inpatient stays, emergency room visits, or urgent care visits
G9790	Most rct bp >/= 140/90	Most recent bp is greater than 140/90 mm hg, or blood pressure not documented
G9791	Most rct tob stat free	Most recent tobacco status is tobacco free
G9792	Most rct tob stat not free	Most recent tobacco status is not tobacco free
G9793	Pt on daily asa/antiplat	Patient is currently on a daily aspirin or other antiplatelet
G9794	Doc med rsn no daily aspirin	Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)
G9795	Pt no daily asa/antiplat	Patient is not currently on a daily aspirin or other antiplatelet
G9796	Pt not currently on statin	Patient is currently on a statin therapy
G9797	Pt currently on statin	Patient is not on a statin therapy
G9798	D/c ami btw 7/1-6/30 meas pd	Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period
G9799	Med disp evt indic hx asth	Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period
G9800	Pt id intol/alleg beta-block	Patients who are identified as having an intolerance or allergy to beta-blocker therapy
G9801	Nonacut transf from inpt	Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis
G9802	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9803	Pt presc 135 day trmt	Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
G9804	Pt not presc 135 day trmt	Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
G9805	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9806	Pt recd cerv cyto/hpv	Patients who received cervical cytology or an hpv test
G9807	Pt no recd cerv cyto/hpv	Patients who did not receive cervical cytology or an hpv test
G9808	Pt no asthm cont med mst per	Any patients who had no asthma controller medications dispensed during the measurement year
G9809	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9810	Pdc 75% w/asth cont med	Patient achieved a pdc of at least 75% for their asthma controller medication
G9811	No pdc 75% w/asth cont med	Patient did not achieve a pdc of at least 75% for their asthma controller medication
G9812	Pt died during inpt/30d aft	Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure
G9813	Pt not died w/in 30d of proc	Patient did not die within 30 days of the procedure or during the index hospitalization
G9814	Death during index hosp	Death occurring during the index acute care hospitalization
G9815	Death not during index hosp	Death did not occur during the index acute care hospitalization
G9816	Death <30 day post discharge	Death occurring after discharge from the hospital but within 30 days post procedure
G9817	No death 30-days post-disch	Death did not occur after discharge from the hospital within 30 days post procedure
G9818	Doc sex activity	Documentation of sexual activity
G9819	Pt w/hosp anytime msmt per	Patients who use hospice services any time during the measurement period
G9820	Doc chlam scr test w/follow	Documentation of a chlamydia screening test with proper follow-up
G9821	No doc chlam scr ts w/follow	No documentation of a chlamydia screening test with proper follow-up
G9822	Endo abl proc yr prev ind dt	Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date)
G9823	Endo smpl/hyst bx res doc	Endometrial sampling or hysteroscopy with biopsy and results documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation
G9824	Endo smpl/hyst bx res no doc	Endometrial sampling or hysteroscopy with biopsy and results not documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation
G9825	Her-2 neg,undoc/unkn	Her-2/neu negative or undocumented/unknown
G9826	Transf pract aft init chemo	Patient transferred to practice after initiation of chemotherapy
G9827	Her-2 targ ther no init tx	Her2-targeted therapies not administered during the initial course of treatment
G9828	Her-2 targ ther dur init tx	Her2-targeted therapies administered during the initial course of treatment
G9829	Breast adj chemo admin	Breast adjuvant chemotherapy administered
G9830	Her-2 pos	Her-2/neu positive
G9831	Ajcc stg brt ca dx ii or iii	Ajcc stage at breast cancer diagnosis = ii or iii
G9832	Brt ca dx i, no t1/t1a/t1b	Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis does not equal = t1, t1a, t1b
G9833	Transf pract aft init chemo	Patient transfer to practice after initiation of chemotherapy
G9834	Pt met dis at dx	Patient has metastatic disease at diagnosis
G9835	Trastuz given w/in 12 mos dx	Trastuzumab administered within 12 months of diagnosis
G9836	Rsn no trast given doc	Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
G9837	Trastuz not in 12 mos dx	Trastuzumab not administered within 12 months of diagnosis
G9838	Pt met dis at dx	Patient has metastatic disease at diagnosis
G9839	Anti-egfr mon anti ther	Anti-egfr monoclonal antibody therapy
G9840	Gene testing performed	Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab
G9841	Gene testing not performed	Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab
G9842	Pt met dis at dx	Patient has metastatic disease at diagnosis
G9843	Kras or nras gene mutation	Ras (kras or nras) gene mutation
G9844	Pt no recd anti-egfr ther	Patient did not receive anti-egfr monoclonal antibody therapy
G9845	Pt recd anti-egfr ther	Patient received anti-egfr monoclonal antibody therapy
G9846	Pt died from cancer	Patients who died from cancer
G9847	Pt recd chemo last 14d life	Patient received systemic cancer-directed therapy in the last 14 days of life
G9848	Pt no chemo last 14d life	Patient did not receive systemic cancer-directed therapy in the last 14 days of life
G9849	Pt died from cancer	Patients who died from cancer
G9850	1/more ed last 30d life	Patient had more than one emergency department visit in the last 30 days of life
G9851	1/no ed visit last 30d life	Patient had one or less emergency department visits in the last 30 days of life
G9852	Pt died from cancer	Patients who died from cancer
G9853	Icu stay last 30d life	Patient admitted to the icu in the last 30 days of life
G9854	No icu stay last 30d life	Patient was not admitted to the icu in the last 30 days of life
G9855	Pt died from cancer	Patients who died from cancer
G9856	Pt no hospice	Patient was not admitted to hospice
G9857	Pt admit hospice	Patient admitted to hospice
G9858	Pt enroll hospice	Patient enrolled in hospice
G9859	Pt died from cancer	Patients who died from cancer
G9860	Pt less 3d hospice	Patient spent less than three days in hospice care
G9861	Pt more than 3d hospice	Patient spent greater than or equal to three days in hospice care
G9862	Doc rsn no 10 yr follow	Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)
G9868	Cmmi asyntelehealth <10min	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes
G9869	Cmmi asyntelehealth 10-20min	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes
G9870	Cmmi asyntelehealth >20min	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes
G9873	1 em core session	First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9874	4 em core sessions	Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9875	9 em core sessions	Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9876	2 em core ms mo 7-9 no wl	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9
G9877	2 em core ms mo 10-12 no wl	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12
G9878	2 em core ms mo 7-9 wl	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions.the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9
G9879	2 em core ms mo 10-12 wl	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12
G9880	Em 5 percent wl	The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session
G9881	Em 9 percent wl	The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session
G9882	2 em ongoing ms mo 13-15 wl	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15
G9883	2 em ongoing ms mo 16-18 wl	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18
G9884	2 em ongoing ms mo 19-21 wl	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21
G9885	2 em ongoing ms mo 22-24 wl	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 22-24 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24
G9886	In-person attendance g code	Behavioral counseling for diabetes prevention, in-person, group, 60 minutes
G9887	Distance learning attendance	Behavioral counseling for diabetes prevention, distance learning, 60 minutes
G9888	5% wl maintnd from bsline wt	Maintenance 5% wl from baseline weight in months 7-12
G9890	Em bridge payment	Bridge payment: a one-time payment for the first medicare diabetes prevention program (mdpp) core session, core maintenance session, or ongoing maintenance session furnished by an mdpp supplier to an mdpp beneficiary during months 1-24 of the mdpp expanded model (em) who has previously received mdpp services from a different mdpp supplier under the mdpp expanded model. a supplier may only receive one bridge payment per mdpp beneficiary
G9891	Em session reporting	Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)
G9892	Doc pt rsn no dil mac exam	Documentation of patient reason(s) for not performing a dilated macular examination
G9893	No mac exam	Dilated macular exam was not performed, reason not otherwise specified
G9894	Adr dep thrpy prescribed	Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate
G9895	Doc med rsn no adr dep thrpy	Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)
G9896	Doc pt rsn no adr dep thrpy	Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate
G9897	Pt nt prsc adr dep thrpy rng	Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given
G9898	Pt 66+ snp or ltc pos > 90d	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 consecutive days during the measurement period
G9899	Scrn mam perf rslts doc	Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed
G9900	Scrn mam perf rslts not doc	Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
G9901	Pt 66+ snp or ltc pos > 90d	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
G9902	Pt scrn tbco and id as user	Patient screened for tobacco use and identified as a tobacco user
G9903	Pt scrn tbco id as non user	Patient screened for tobacco use and identified as a tobacco non-user
G9904	Doc med rsn no tbco scrn	Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
G9905	No pt tbco scrn rng	Patient not screened for tobacco use
G9906	Pt recv tbco cess interv	Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
G9907	Doc med rsn no tbco interv	Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months (e.g., limited life expectancy, other medical reason)
G9908	No pt tbco cess interv rng	Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
G9909	Doc med rsn no tbco interv	Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason)
G9910	Pt 66+ snp or ltc pos > 90d	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 consecutive days during the measurement period
G9911	Node neg pre/post syst ther	Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
G9912	Hbv status assesed and int	Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy
G9913	No hbv status assesd and int	Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not otherwise specified
G9914	Pt initiated anti-tnf agent	Patient initiated an anti-tnf agent
G9915	No documntd hbv results rcd	No record of hbv results documented
G9916	Funct status past 12 months	Functional status performed once in the last 12 months
G9917	Adv dem crgvr limited	Documentation of advanced stage dementia and caregiver knowledge is limited
G9918	No funct stat perf, rsn nos	Functional status not performed, reason not otherwise specified
G9919	Scrn nd pos nd prov of rec	Screening performed and positive and provision of recommendations
G9920	Scrning perf and negative	Screening performed and negative
G9921	No or part scrn nd rng or os	No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified
G9922	Sfty cncrns scrn nd mit recs	Safety concerns screen provided and if positive then documented mitigation recommendations
G9923	Safty cncrns scrn and neg	Safety concerns screen provided and negative
G9924	Doc med rsn no scrn or recs	Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)
G9925	No scrn prov rsn nos	Safety concerns screening not provided, reason not otherwise specified
G9926	Sfty cncrns scrn but no recs	Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources
G9927	Doc no warf /fda pt trial	Documentation of system reason(s) for not prescribing an fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment
G9928	No warf or fda drug presc	Fda-approved anticoagulant not prescribed, reason not given
G9929	Trs/rev af	Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9930	Com care	Patients who are receiving comfort care only
G9931	No chad or chad scr 0 or 1	Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women
G9932	Doc pt rsn no tb scrn recrds	Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)
G9933	Canc detectd during col scrn	Adenoma(s) or colorectal cancer detected during screening colonoscopy
G9934	Doc rsn not detecting cancer	Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
G9935	Canc not detectd during srcn	Adenoma(s) or colorectal cancer not detected during screening colonoscopy
G9936	Pmh plyp/neo co/rect/jun/ans	Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
G9937	Dig or surv colsco	Diagnostic colonoscopy
G9938	Pt 66+ snp or ltc pos > 90d	Patients aged 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 six months prior to the measurement period through december 31 of the measurement period
G9939	Same path/derm perf biopsy	Pathologists/dermatopathologists is the same clinician who performed the biopsy
G9940	Doc reas no statin therapy	Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)
G9941	Pre and post vas wthn 3 mos	Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
G9942	Adtl spine proc on same date	Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
G9943	Bk pn nt msr vas scl pre/pst	Back pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
G9944	Vas 3 mon pre and 1 yr post	Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9945	Pt w/cancer scoliosis	Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
G9946	Bk pain no vas	Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
G9947	Pre and post vas wthn 3 mos	Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
G9948	Adtl spine proc on same date	Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
G9949	Leg pain no vas	Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
G9954	Pt >2 rsk fac post-op vomit	Patient exhibits 2 or more risk factors for post-operative vomiting
G9955	Inhlnt anesth only for induc	Cases in which an inhalational anesthetic is used only for induction
G9956	Combo thrpy of >= 2 prophly	Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9957	Doc med rsn no combo thrpy	Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9958	No combo prohpyl thrp for pt	Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9959	Systemic antimicro not presc	Systemic antimicrobials not prescribed
G9960	Med rsn sys antimi nt rx	Documentation of medical reason(s) for prescribing systemic antimicrobials
G9961	Systemic antimicro presc	Systemic antimicrobials prescribed
G9962	Embolization doc separatly	Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy
G9963	Embolization not doc separat	Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy
G9964	Pt recv >=1 well-chld visit	Patient received at least one well-child visit with a pcp during the performance period
G9965	No well-chld vist recv by pt	Patient did not receive at least one well-child visit with a pcp during the performance period
G9966	Scrn, inter, report child	Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9967	No scrn, inter, reprt child	Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9968	Pt refrd 2 pvdr/spclst in pp	Patient was referred to another clinician or specialist during the measurement period
G9969	Pvdr rfrd pt rprt rcvd	Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred
G9970	Pvdr rfrd pt no rprt rcvd	Clinician who referred the patient to another clinician did not receive a report from the clinician to whom the patient was referred
G9974	Mac exam perf	Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity
G9975	Doc med rsn no dil mac exam	Documentation of medical reason(s) for not performing a dilated macular examination
G9978	Remote e/m new pt 10mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9979	Remote e/m new pt 20mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9980	Remote e/m new pt 30 mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9981	Remote e/m new pt 45mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9982	Remote e/m new pt 60mins	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9983	Remote e/m est. pt 10mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9984	Remote e/m est. pt 15mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9985	Remote e/m est. pt 25mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9986	Remote e/m est. pt 40mins	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9987	Bpci advanced in home visit	Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code
G9988	Pall serv during meas	Palliative care services provided to patient any time during the measurement period
G9989	Med rsn no pneum vax	Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., adverse reaction to vaccine)
G9990	No pneum vax admin 19+	Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
G9991	Pneum vax admin 19+	Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
G9992	Pall serv during meas	Palliative care services used by patient any time during the measurement period
G9993	Pall serv during meas	Patient was provided palliative care services any time during the measurement period
G9994	Pall serv during meas	Patient is using palliative care services any time during the measurement period
G9995	Pall serv during meas	Patients who use palliative care services any time during the measurement period
G9996	Doc pt pal or hospice	Documentation stating the patient has received or is currently receiving palliative or hospice care
G9997	Doc pt preg dur msrmt pd	Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
G9998	Doc med rsn <3 colon	Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])
G9999	Doc sys rsn <3 colon	Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, previous colonoscopy report was incomplete)
GA	Liability waiver ind case	Waiver of liability statement issued as required by payer policy, individual case
GB	Claim resubmitted	Claim being re-submitted for payment because it is no longer covered under a global payment demonstration
GC	Resident/teaching phys serv	This service has been performed in part by a resident under the direction of a teaching physician
GD	Unit of service > mue value	Units of service exceeds medically unlikely edit value and represents reasonable and necessary services
GE	Resident prim care exception	This service has been performed by a resident without the presence of a teaching physician under the primary care exception
GF	Nonphysician serv c a hosp	Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GG	Payment screen mam + diagmam	Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day
GH	Diag mammo to screening mamo	Diagnostic mammogram converted from screening mammogram on same day
GJ	Opt out provider of er srvc	opt out physician or practitioner emergency or urgent service
GK	Actual item/service ordered	Reasonable and necessary item/service associated with a ga or gz modifier
GL	Upgraded item, no charge	Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GM	Multiple transports	Multiple patients on one ambulance trip
GN	Op speech language service	Services delivered under an outpatient speech language pathology plan of care
GO	Op occupational therapy serv	Services delivered under an outpatient occupational therapy plan of care
GP	Op pt services	Services delivered under an outpatient physical therapy plan of care
GQ	Telehealth store and forward	Via asynchronous telecommunications system
GR	Service by va resident	This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy
GS	Epo/darbepoietin reduced 25%	Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
GT	Interactivetelecommunication	Via interactive audio and video telecommunication systems
GU	Liability waiver rout notice	Waiver of liability statement issued as required by payer policy, routine notice
GV	Attending phys not hospice	Attending physician not employed or paid under arrangement by the patient's hospice provider
GW	Service unrelated to term co	Service not related to the hospice patient's terminal condition
GX	Voluntary liability notice	Notice of liability issued, voluntary under payer policy
GY	Statutorily excluded	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ	Not reasonable and necessary	Item or service expected to be denied as not reasonable and necessary