List of HCPCS codes for: Temporary Procedures & Professional Services (G-codes) - Group G9



HCPCS Code: G9
Short Description: Mac for at risk patient
Long Description: Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition

HCPCS Code: G9001
Short Description: Mccd, initial rate
Long Description: Coordinated care fee, initial rate

HCPCS Code: G9002
Short Description: Mccd,maintenance rate
Long Description: Coordinated care fee, maintenance rate

HCPCS Code: G9003
Short Description: Mccd, risk adj hi, initial
Long Description: Coordinated care fee, risk adjusted high, initial

HCPCS Code: G9004
Short Description: Mccd, risk adj lo, initial
Long Description: Coordinated care fee, risk adjusted low, initial

HCPCS Code: G9005
Short Description: Mccd, risk adj, maintenance
Long Description: Coordinated care fee, risk adjusted maintenance

HCPCS Code: G9006
Short Description: Mccd, home monitoring
Long Description: Coordinated care fee, home monitoring

HCPCS Code: G9007
Short Description: Mccd, sch team conf
Long Description: Coordinated care fee, scheduled team conference

HCPCS Code: G9008
Short Description: Mccd,phys coor-care ovrsght
Long Description: Coordinated care fee, physician coordinated care oversight services

HCPCS Code: G9009
Short Description: Mccd, risk adj, level 3
Long Description: Coordinated care fee, risk adjusted maintenance, level 3

HCPCS Code: G9010
Short Description: Mccd, risk adj, level 4
Long Description: Coordinated care fee, risk adjusted maintenance, level 4

HCPCS Code: G9011
Short Description: Mccd, risk adj, level 5
Long Description: Coordinated care fee, risk adjusted maintenance, level 5

HCPCS Code: G9012
Short Description: Other specified case mgmt
Long Description: Other specified case management service not elsewhere classified

HCPCS Code: G9013
Short Description: Esrd demo bundle level i
Long Description: Esrd demo basic bundle level i

HCPCS Code: G9014
Short Description: Esrd demo bundle-level ii
Long Description: Esrd demo expanded bundle including venous access and related services

HCPCS Code: G9016
Short Description: Demo-smoking cessation coun
Long Description: 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]

HCPCS Code: G9017
Short Description: Amantadine hcl 100mg oral
Long Description: Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9018
Short Description: Zanamivir,inhalation pwd 10m
Long Description: Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9019
Short Description: Oseltamivir phosphate 75mg
Long Description: Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9020
Short Description: Rimantadine hcl 100mg oral
Long Description: Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9033
Short Description: Amantadine hcl oral brand
Long Description: Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9034
Short Description: Zanamivir, inh pwdr, brand
Long Description: Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9035
Short Description: Oseltamivir phosp, brand
Long Description: Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9036
Short Description: Rimantadine hcl, brand
Long Description: Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)

HCPCS Code: G9050
Short Description: Oncology work-up evaluation
Long Description: 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)

HCPCS Code: G9051
Short Description: Oncology tx decision-mgmt
Long Description: 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)

HCPCS Code: G9052
Short Description: Onc surveillance for disease
Long Description: 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)

HCPCS Code: G9053
Short Description: Onc expectant management pt
Long Description: 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)

HCPCS Code: G9054
Short Description: Onc supervision palliative
Long Description: 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)

HCPCS Code: G9055
Short Description: Onc visit unspecified nos
Long Description: Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)

HCPCS Code: G9056
Short Description: Onc prac mgmt adheres guide
Long Description: Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)

HCPCS Code: G9057
Short Description: Onc pract mgmt differs trial
Long Description: 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)

HCPCS Code: G9058
Short Description: Onc prac mgmt disagree w/gui
Long Description: Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)

HCPCS Code: G9059
Short Description: Onc prac mgmt pt opt alterna
Long Description: 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)

HCPCS Code: G9060
Short Description: Onc prac mgmt dif pt comorb
Long Description: 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)

HCPCS Code: G9061
Short Description: Onc prac cond noadd by guide
Long Description: Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)

HCPCS Code: G9062
Short Description: Onc prac guide differs nos
Long Description: Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)

HCPCS Code: G9063
Short Description: Onc dx nsclc stgi no progres
Long Description: 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)

HCPCS Code: G9064
Short Description: Onc dx nsclc stg2 no progres
Long Description: 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)

HCPCS Code: G9065
Short Description: Onc dx nsclc stg3a no progre
Long Description: 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)

HCPCS Code: G9066
Short Description: Onc dx nsclc stg3b-4 metasta
Long Description: 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)

HCPCS Code: G9067
Short Description: Onc dx nsclc dx unknown nos
Long Description: 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)

HCPCS Code: G9068
Short Description: Onc dx sclc/nsclc limited
Long Description: 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)

HCPCS Code: G9069
Short Description: Onc dx sclc/nsclc ext at dx
Long Description: 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)

HCPCS Code: G9070
Short Description: Onc dx sclc/nsclc ext unknwn
Long Description: 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)

HCPCS Code: G9071
Short Description: Onc dx brst stg1-2b hr,nopro
Long Description: 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)

HCPCS Code: G9072
Short Description: Onc dx brst stg1-2 noprogres
Long Description: 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)

HCPCS Code: G9073
Short Description: Onc dx brst stg3-hr, no pro
Long Description: 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)

HCPCS Code: G9074
Short Description: Onc dx brst stg3-noprogress
Long Description: 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)

HCPCS Code: G9075
Short Description: Onc dx brst metastic/ recur
Long Description: 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)

HCPCS Code: G9077
Short Description: Onc dx prostate t1no progres
Long Description: 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)

HCPCS Code: G9078
Short Description: Onc dx prostate t2no progres
Long Description: 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)

HCPCS Code: G9079
Short Description: Onc dx prostate t3b-t4noprog
Long Description: 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)

HCPCS Code: G9080
Short Description: Onc dx prostate w/rise psa
Long Description: 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)

HCPCS Code: G9083
Short Description: Onc dx prostate unknwn nos
Long Description: 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)

HCPCS Code: G9084
Short Description: Onc dx colon t1-3,n1-2,no pr
Long Description: 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)

HCPCS Code: G9085
Short Description: Onc dx colon t4, n0 w/o prog
Long Description: 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)

HCPCS Code: G9086
Short Description: Onc dx colon t1-4 no dx prog
Long Description: 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)

HCPCS Code: G9087
Short Description: Onc dx colon metas evid dx
Long Description: 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)

HCPCS Code: G9088
Short Description: Onc dx colon metas noevid dx
Long Description: 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)

HCPCS Code: G9089
Short Description: Onc dx colon extent unknown
Long Description: 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)

HCPCS Code: G9090
Short Description: Onc dx rectal t1-2 no progr
Long Description: 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)

HCPCS Code: G9091
Short Description: Onc dx rectal t3 n0 no prog
Long Description: 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)

HCPCS Code: G9092
Short Description: Onc dx rectal t1-3,n1-2noprg
Long Description: 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)

HCPCS Code: G9093
Short Description: Onc dx rectal t4,n,m0 no prg
Long Description: 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)

HCPCS Code: G9094
Short Description: Onc dx rectal m1 w/mets prog
Long Description: 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)

HCPCS Code: G9095
Short Description: Onc dx rectal extent unknwn
Long Description: 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)

HCPCS Code: G9096
Short Description: Onc dx esophag t1-t3 noprog
Long Description: 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)

HCPCS Code: G9097
Short Description: Onc dx esophageal t4 no prog
Long Description: 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)

HCPCS Code: G9098
Short Description: Onc dx esophageal mets recur
Long Description: 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)

HCPCS Code: G9099
Short Description: Onc dx esophageal unknown
Long Description: 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)

HCPCS Code: G9100
Short Description: Onc dx gastric no recurrence
Long Description: 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)

HCPCS Code: G9101
Short Description: Onc dx gastric p r1-r2noprog
Long Description: 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)

HCPCS Code: G9102
Short Description: Onc dx gastric unresectable
Long Description: 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)

HCPCS Code: G9103
Short Description: Onc dx gastric recurrent
Long Description: 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)

HCPCS Code: G9104
Short Description: Onc dx gastric unknown nos
Long Description: 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)

HCPCS Code: G9105
Short Description: Onc dx pancreatc p r0 res no
Long Description: 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)

HCPCS Code: G9106
Short Description: Onc dx pancreatc p r1/r2 no
Long Description: 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)

HCPCS Code: G9107
Short Description: Onc dx pancreatic unresectab
Long Description: 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)

HCPCS Code: G9108
Short Description: Onc dx pancreatic unknwn nos
Long Description: 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)

HCPCS Code: G9109
Short Description: Onc dx head/neck t1-t2no prg
Long Description: 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)

HCPCS Code: G9110
Short Description: Onc dx head/neck t3-4 noprog
Long Description: 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)

HCPCS Code: G9111
Short Description: Onc dx head/neck m1 mets rec
Long Description: 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)

HCPCS Code: G9112
Short Description: Onc dx head/neck ext unknown
Long Description: 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)

HCPCS Code: G9113
Short Description: Onc dx ovarian stg1a-b no pr
Long Description: 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)

HCPCS Code: G9114
Short Description: Onc dx ovarian stg1a-b or 2
Long Description: 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)

HCPCS Code: G9115
Short Description: Onc dx ovarian stg3/4 noprog
Long Description: 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)

HCPCS Code: G9116
Short Description: Onc dx ovarian recurrence
Long Description: 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)

HCPCS Code: G9117
Short Description: Onc dx ovarian unknown nos
Long Description: 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)

HCPCS Code: G9123
Short Description: Onc dx cml chronic phase
Long Description: 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)

HCPCS Code: G9124
Short Description: Onc dx cml acceler phase
Long Description: 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)

HCPCS Code: G9125
Short Description: Onc dx cml blast phase
Long Description: 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)

HCPCS Code: G9126
Short Description: Onc dx cml remission
Long Description: 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)

HCPCS Code: G9128
Short Description: Onc dx multi myeloma stage i
Long Description: Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)

HCPCS Code: G9129
Short Description: Onc dx mult myeloma stg2 hig
Long Description: Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)

HCPCS Code: G9130
Short Description: Onc dx multi myeloma unknown
Long Description: 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)

HCPCS Code: G9131
Short Description: Onc dx brst unknown nos
Long Description: 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)

HCPCS Code: G9132
Short Description: Onc dx prostate mets no cast
Long Description: 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)

HCPCS Code: G9133
Short Description: Onc dx prostate clinical met
Long Description: Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)

HCPCS Code: G9134
Short Description: Onc nhlstg 1-2 no relap no
Long Description: 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)

HCPCS Code: G9135
Short Description: Onc dx nhl stg 3-4 not relap
Long Description: 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)

HCPCS Code: G9136
Short Description: Onc dx nhl trans to lg bcell
Long Description: 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)

HCPCS Code: G9137
Short Description: Onc dx nhl relapse/refractor
Long Description: Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)

HCPCS Code: G9138
Short Description: Onc dx nhl stg unknown
Long Description: 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)

HCPCS Code: G9139
Short Description: Onc dx cml dx status unknown
Long Description: 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)

HCPCS Code: G9140
Short Description: Frontier extended stay demo
Long Description: 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

HCPCS Code: G9141
Short Description: Influenza a h1n1,admin w cou
Long Description: Influenza a (h1n1) immunization administration (includes the physician counseling the patient/family)

HCPCS Code: G9142
Short Description: Influenza a h1n1, vaccine
Long Description: Influenza a (h1n1) vaccine, any route of administration

HCPCS Code: G9143
Short Description: Warfarin respon genetic test
Long Description: Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)

HCPCS Code: G9147
Short Description: Outpt iv insulin tx any mea
Long Description: 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

HCPCS Code: G9148
Short Description: Medical home level 1
Long Description: National committee for quality assurance - level 1 medical home

HCPCS Code: G9149
Short Description: Medical home level ii
Long Description: National committee for quality assurance - level 2 medical home

HCPCS Code: G9150
Short Description: Medical home level iii
Long Description: National committee for quality assurance - level 3 medical home

HCPCS Code: G9151
Short Description: Mapcp demo state
Long Description: Mapcp demonstration - state provided services

HCPCS Code: G9152
Short Description: Mapcp demo community
Long Description: Mapcp demonstration - community health teams

HCPCS Code: G9153
Short Description: Mapcp demo physician
Long Description: Mapcp demonstration - physician incentive pool

HCPCS Code: G9156
Short Description: Evaluation for wheelchair
Long Description: Evaluation for wheelchair requiring face to face visit with physician

HCPCS Code: G9157
Short Description: Transesoph doppl cardiac mon
Long Description: Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes

HCPCS Code: G9158
Short Description: Motor speech d/c status
Long Description: Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting

HCPCS Code: G9159
Short Description: Lang comp current status
Long Description: Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9160
Short Description: Lang comp goal status
Long Description: Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9161
Short Description: Lang comp d/c status
Long Description: Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting

HCPCS Code: G9162
Short Description: Lang express current status
Long Description: Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9163
Short Description: Lang express goal status
Long Description: Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9164
Short Description: Lang express d/c status
Long Description: Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting

HCPCS Code: G9165
Short Description: Atten current status
Long Description: Attention functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9166
Short Description: Atten goal status
Long Description: Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9167
Short Description: Atten d/c status
Long Description: Attention functional limitation, discharge status at discharge from therapy or to end reporting

HCPCS Code: G9168
Short Description: Memory current status
Long Description: Memory functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9169
Short Description: Memory goal status
Long Description: Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9170
Short Description: Memory d/c status
Long Description: Memory functional limitation, discharge status at discharge from therapy or to end reporting

HCPCS Code: G9171
Short Description: Voice current status
Long Description: Voice functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9172
Short Description: Voice goal status
Long Description: Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9173
Short Description: Voice d/c status
Long Description: Voice functional limitation, discharge status at discharge from therapy or to end reporting

HCPCS Code: G9174
Short Description: Speech lang current status
Long Description: Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals

HCPCS Code: G9175
Short Description: Speech lang goal status
Long Description: Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9176
Short Description: Speech lang d/c status
Long Description: Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting

HCPCS Code: G9186
Short Description: Motor speech goal status
Long Description: Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

HCPCS Code: G9187
Short Description: Bpci home visit
Long Description: 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

HCPCS Code: G9188
Short Description: Beta not given no reason
Long Description: Beta-blocker therapy not prescribed, reason not given

HCPCS Code: G9189
Short Description: Beta pres or already taking
Long Description: Beta-blocker therapy prescribed or currently being taken

HCPCS Code: G9190
Short Description: Medical reason for no beta
Long Description: Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)

HCPCS Code: G9191
Short Description: Pt reason for no beta
Long Description: Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)

HCPCS Code: G9192
Short Description: System reason for no beta
Long Description: Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)

HCPCS Code: G9193
Short Description: Doc not eligible for dep med
Long Description: Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression

HCPCS Code: G9194
Short Description: Mdd pt treated for 180d
Long Description: Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase

HCPCS Code: G9195
Short Description: Mdd pt not treated for 180d
Long Description: Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase

HCPCS Code: G9196
Short Description: Med reason for no ceph
Long Description: Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))

HCPCS Code: G9197
Short Description: Order for ceph
Long Description: Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis

HCPCS Code: G9198
Short Description: No order for ceph no reason
Long Description: Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given

HCPCS Code: G9199
Short Description: Doc reason for no vte
Long Description: Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))

HCPCS Code: G9200
Short Description: No reason for no vte
Long Description: Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given

HCPCS Code: G9201
Short Description: Vte given upon admission
Long Description: Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission

HCPCS Code: G9202
Short Description: Hep c aby pos
Long Description: Patients with a positive hepatitis c antibody test

HCPCS Code: G9203
Short Description: Hep c rna done prior to med
Long Description: Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c

HCPCS Code: G9204
Short Description: No reason for no hep c rna
Long Description: Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given

HCPCS Code: G9205
Short Description: Hep c antiviral started
Long Description: Patient starting antiviral treatmentfor hepatitis c during the measurement period

HCPCS Code: G9206
Short Description: Hep c therapy started
Long Description: Patient starting antiviral treatment for hepatitis c during the measurement period

HCPCS Code: G9207
Short Description: Hep c genotype prior to med
Long Description: Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c

HCPCS Code: G9208
Short Description: No reason for no hep c geno
Long Description: Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given

HCPCS Code: G9209
Short Description: Hep c rna 4to12 wk after med
Long Description: Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment

HCPCS Code: G9210
Short Description: No hepc rna after med docrsn
Long Description: Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)

HCPCS Code: G9211
Short Description: No hepc rna after med no rsn
Long Description: Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given

HCPCS Code: G9212
Short Description: Doc of dsm-iv init eval
Long Description: Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation

HCPCS Code: G9213
Short Description: No doc of dsm-iv
Long Description: Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified

HCPCS Code: G9214
Short Description: Cd4 count documented
Long Description: Cd4+ cell count or cd4+ cell percentage results documented

HCPCS Code: G9215
Short Description: No cd4 count no reason
Long Description: Cd4+ cell count or percentage not documented as performed, reason not given

HCPCS Code: G9216
Short Description: No pcp proph at dx no reason
Long Description: Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given

HCPCS Code: G9217
Short Description: No pcp proph low cd4 norsn
Long Description: Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given

HCPCS Code: G9218
Short Description: No pcp prop low at cd4 norsn
Long Description: Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given

HCPCS Code: G9219
Short Description: No oder pjp for med reason
Long Description: Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

HCPCS Code: G9220
Short Description: No order for pjp for medrsn
Long Description: Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

HCPCS Code: G9221
Short Description: Pjp proph prescribed
Long Description: Pneumocystis jiroveci pneumonia prophlaxis prescribed

HCPCS Code: G9222
Short Description: Pjp proph ordered low cd4
Long Description: Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3

HCPCS Code: G9223
Short Description: Pjp proph ordered cd4 low
Long Description: Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%

HCPCS Code: G9224
Short Description: Medrsn no foot exam
Long Description: Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)

HCPCS Code: G9225
Short Description: Norsn no foot exam
Long Description: Foot exam was not performed, reason not given

HCPCS Code: G9226
Short Description: 3 comp foot exam completed
Long Description: 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)

HCPCS Code: G9227
Short Description: Docrsn no care plan
Long Description: Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan

HCPCS Code: G9228
Short Description: Gc chl syp documented
Long Description: Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)

HCPCS Code: G9229
Short Description: Ptrsn no gc chl syp test
Long Description: Chlamydia, gonorrhea, and syphilis not screened, due to documented reason (patient refusal is the only allowed exclusion)

HCPCS Code: G9230
Short Description: Norsn for gc chl syp test
Long Description: Chlamydia, gonorrhea, and syphilis not screened, reason not given

HCPCS Code: G9231
Short Description: Doc esrd dia trans preg
Long Description: Documentation of end stage renal disease (esrd), dialysis, renal transplant or pregnancy

HCPCS Code: G9232
Short Description: Docrsn no comm comorb
Long Description: Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason

HCPCS Code: G9233
Short Description: Tkr composite
Long Description: All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient

HCPCS Code: G9234
Short Description: Tkr intent
Long Description: I intend to report the total knee replacement measures group

HCPCS Code: G9235
Short Description: Gs mg composite
Long Description: All quality actions for the applicable measures in the general surgery measures group have been performed for this patient

HCPCS Code: G9236
Short Description: Op rad mg composite
Long Description: All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient

HCPCS Code: G9237
Short Description: Gs mg intent
Long Description: I intend to report the general surgery measures group

HCPCS Code: G9238
Short Description: Op rad mg intent
Long Description: I intend to report the optimizing patient exposure to ionizing radiation measures group

HCPCS Code: G9239
Short Description: Docrsn for catheter
Long Description: Documentation of reasons for patient initiaiting maintenance hemodialysis with a catheter as the mode of vascular access (eg, patient has a maturing avf/avg, time-limited trial of hemodialysis, patients undergoing palliative dialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)

HCPCS Code: G9240
Short Description: Doc pt w cath maint dia
Long Description: Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated

HCPCS Code: G9241
Short Description: Doc pt w out cath maint dia
Long Description: Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated

HCPCS Code: G9242
Short Description: Doc viral load >=200
Long Description: Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed

HCPCS Code: G9243
Short Description: Doc viral load <200
Long Description: Documentation of viral load less than 200 copies/ml

HCPCS Code: G9244
Short Description: Antiviral not ordered
Long Description: Antiretroviral thereapy not prescribed

HCPCS Code: G9245
Short Description: Antiviral ordered
Long Description: Antiretroviral therapy prescribed

HCPCS Code: G9246
Short Description: No med visit in 24mo
Long Description: 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

HCPCS Code: G9247
Short Description: 1 med visit in 24mo
Long Description: 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

HCPCS Code: G9248
Short Description: No med visit 6mo
Long Description: Patient did not have a medical visit in the last 6 months

HCPCS Code: G9249
Short Description: Med visit w in 6mo
Long Description: Patient had a medical visit in the last 6 months

HCPCS Code: G9250
Short Description: Doc of pain comfort 48hr
Long Description: Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment

HCPCS Code: G9251
Short Description: Doc no pain comfort 48hr
Long Description: Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment

HCPCS Code: G9252
Short Description: Neo detect scrn colo
Long Description: Adenoma(s) or other neoplasm detected during screening colonoscopy

HCPCS Code: G9253
Short Description: No neo detect scrn colo
Long Description: Adenoma(s) or other neoplasm not detected during screening colonoscopy

HCPCS Code: G9254
Short Description: Doc pt dischg >2d
Long Description: Documentation of patient discharged to home later than post-operative day 2 following cas

HCPCS Code: G9255
Short Description: Doc pt dischg <=2d
Long Description: Documentation of patient discharged to home no later than post operative day 2 following cas

HCPCS Code: G9256
Short Description: Doc death after cas
Long Description: Documentation of patient death following cas

HCPCS Code: G9257
Short Description: Doc stroke after cas
Long Description: Documentation of patient stroke following cas

HCPCS Code: G9258
Short Description: Doc stroke after cea
Long Description: Documentation of patient stroke following cea

HCPCS Code: G9259
Short Description: Doc surv no stroke after cas
Long Description: Documentation of patient survival and absence of stroke following cas

HCPCS Code: G9260
Short Description: Doc death after cea
Long Description: Documentation of patient death following cea

HCPCS Code: G9261
Short Description: Doc surv no stroke after cea
Long Description: Documentation of patient survival and absence of stroke following cea

HCPCS Code: G9262
Short Description: Doc death in hosp aaa repair
Long Description: Documentation of patient death in the hospital following endovascular aaa repair

HCPCS Code: G9263
Short Description: Doc surv in hosp aaa repair
Long Description: Documentation of patient survival in the hospital following endovascular aaa repair

HCPCS Code: G9264
Short Description: Docrsn for cath maint dia
Long Description: Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (eg, patient is undergoing palliative dialysis with a catheter, patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant, other medical reasons, patient declined avf/avg, other patient reasons)

HCPCS Code: G9265
Short Description: Doc cath >90d for maint dia
Long Description: Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access

HCPCS Code: G9266
Short Description: Norsn pt cath >=90d
Long Description: Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access

HCPCS Code: G9267
Short Description: Doc comp or mort w in 30d
Long Description: Documentation of patient with one or more complications or mortality within 30 days

HCPCS Code: G9268
Short Description: Doc comp or mort w in 90d
Long Description: Documentation of patient with one or more complications within 90 days

HCPCS Code: G9269
Short Description: Doc no comp or mort w in 30d
Long Description: Documentation of patient without one or more complications and without mortality within 30 days

HCPCS Code: G9270
Short Description: Doc no comp or mort w in 90d
Long Description: Documentation of patient without one or more complications within 90 days

HCPCS Code: G9271
Short Description: Ldl under 100
Long Description: Ldl value < 100

HCPCS Code: G9272
Short Description: Ldl 100 and over
Long Description: Ldl value >= 100

HCPCS Code: G9273
Short Description: Sys<140 and dia<90
Long Description: Blood pressure has a systolic value of < 140 and a diastolic value of < 90

HCPCS Code: G9274
Short Description: Bp out of nrml limits
Long Description: 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

HCPCS Code: G9275
Short Description: Doc of non tobacco user
Long Description: Documentation that patient is a current non-tobacco user

HCPCS Code: G9276
Short Description: Doc of tobacco user
Long Description: Documentation that patient is a current tobacco user

HCPCS Code: G9277
Short Description: Doc daily aspirin or contra
Long Description: 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)

HCPCS Code: G9278
Short Description: Doc no daily aspirin
Long Description: Documentation that the patient is not on daily aspirin or anti-platelet regimen

HCPCS Code: G9279
Short Description: Pne scrn done doc vac done
Long Description: Pneumococcal screening performed and documentation of vaccination received prior to discharge

HCPCS Code: G9280
Short Description: Pne not given norsn
Long Description: Pneumococcal vaccination not administered prior to discharge, reason not specified

HCPCS Code: G9281
Short Description: Pne scrn done doc not ind
Long Description: Screening performed and documentation that vaccination not indicated/patient refusal

HCPCS Code: G9282
Short Description: Doc medrsn no histo type
Long Description: 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)

HCPCS Code: G9283
Short Description: Hist type doc on report
Long Description: Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

HCPCS Code: G9284
Short Description: No hist type doc on report
Long Description: 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

HCPCS Code: G9285
Short Description: Site not small cell lung ca
Long Description: Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer

HCPCS Code: G9286
Short Description: Antibio rx w in 10d of sympt
Long Description: Antibiotic regimen prescribed within10 days after onset of symptoms

HCPCS Code: G9287
Short Description: No antibio w in 10d of sympt
Long Description: Antibiotic regimen not prescribed within 10 days after onset of symptoms

HCPCS Code: G9288
Short Description: Doc medrsn no hist type rpt
Long Description: 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)

HCPCS Code: G9289
Short Description: Doc type nsm lung ca
Long Description: Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

HCPCS Code: G9290
Short Description: No doc type nsm lung ca
Long Description: 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

HCPCS Code: G9291
Short Description: Not nsm lung ca
Long Description: Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos

HCPCS Code: G9292
Short Description: Medrsn no pt category
Long Description: 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)

HCPCS Code: G9293
Short Description: No pt category on report
Long Description: Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

HCPCS Code: G9294
Short Description: Pt cat and thck on report
Long Description: Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

HCPCS Code: G9295
Short Description: Non cutaneous loc
Long Description: Specimen site other than anatomic cutaneous location

HCPCS Code: G9296
Short Description: Doc share dec prior proc
Long Description: 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

HCPCS Code: G9297
Short Description: No doc share dec prior proc
Long Description: 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

HCPCS Code: G9298
Short Description: Eval risk vte card 30d prior
Long Description: 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)

HCPCS Code: G9299
Short Description: No eval riskk vte card prior
Long Description: Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)

HCPCS Code: G9300
Short Description: Doc medrsn no compl antibio
Long Description: Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)

HCPCS Code: G9301
Short Description: Doc compl inf antibio
Long Description: Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet

HCPCS Code: G9302
Short Description: Norsn incomp inf antibio
Long Description: Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given

HCPCS Code: G9303
Short Description: Norsn no pros info op rpt
Long Description: Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given

HCPCS Code: G9304
Short Description: Pros info op rpt
Long Description: Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant

HCPCS Code: G9305
Short Description: No interv req for leak
Long Description: Intervention for presence of leak of endoluminal contents through an anastomosis not required

HCPCS Code: G9306
Short Description: Interv req for leak
Long Description: Intervention for presence of leak of endoluminal contents through an anastomosis required

HCPCS Code: G9307
Short Description: No ret for surg w in 30d
Long Description: No return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure

HCPCS Code: G9308
Short Description: Unplnd ret to surg w in 30d
Long Description: Unplanned return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure

HCPCS Code: G9309
Short Description: No unplnd hosp readm in 30d
Long Description: No unplanned hospital readmission within 30 days of principal procedure

HCPCS Code: G9310
Short Description: Unplnd hosp readm in 30d
Long Description: Unplanned hospital readmission within 30 days of principal procedure

HCPCS Code: G9311
Short Description: No surg site infection
Long Description: No surgical site infection

HCPCS Code: G9312
Short Description: Surgical site infection
Long Description: Surgical site infection

HCPCS Code: G9313
Short Description: Docrsn not first line amox
Long Description: Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason (eg, cystic fibrosis, immotile cilia disorders, ciliary dyskinesia, immune deficiency, prior history of sinus surgery within the past 12 months, and anatomic abnormalities, such as deviated nasal septum, resistant organisms, allergy to medication, recurrent sinusitis, chronic sinusitis, or other reasons)

HCPCS Code: G9314
Short Description: Norsn not first line amox
Long Description: Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given

HCPCS Code: G9315
Short Description: Doc first line amox
Long Description: Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis

HCPCS Code: G9316
Short Description: Doc comm risk calc
Long Description: 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

HCPCS Code: G9317
Short Description: No doc comm risk calc
Long Description: 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

HCPCS Code: G9318
Short Description: Image std nomenclature
Long Description: Imaging study named according to standardized nomenclature

HCPCS Code: G9319
Short Description: Image not std nomenclature
Long Description: Imaging study not named according to standardized nomenclature, reason not given

HCPCS Code: G9320
Short Description: Medrsn no std nomenclature
Long Description: Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

HCPCS Code: G9321
Short Description: Doc count of ct in 12mo
Long Description: 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

HCPCS Code: G9322
Short Description: No doc count of ct in 12mo
Long Description: 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

HCPCS Code: G9323
Short Description: Mdrsn no doc cnt of ct
Long Description: Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

HCPCS Code: G9324
Short Description: Not all data norsn
Long Description: All necessary data elements not included, reason not given

HCPCS Code: G9325
Short Description: Medrsn no ct rpt to reg
Long Description: Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

HCPCS Code: G9326
Short Description: Norsn no ct rpt to reg
Long Description: Ct studies performed not reported to a radiation dose index registry, reason not given

HCPCS Code: G9327
Short Description: Ct rpt to reg
Long Description: Ct studies performed reported to a radiation dose index registry with all necessary data elements

HCPCS Code: G9328
Short Description: Medrsn no dicom format doc
Long Description: Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

HCPCS Code: G9329
Short Description: Norsn no dicom format doc
Long Description: Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given

HCPCS Code: G9340
Short Description: Dicom format doc on rpt
Long Description: Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study

HCPCS Code: G9341
Short Description: Srch for ct w in 12 mos
Long Description: 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

HCPCS Code: G9342
Short Description: No srch for ct in 12mo norsn
Long Description: 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

HCPCS Code: G9343
Short Description: Medrsn no dicom srch
Long Description: Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external heatlhcare 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)

HCPCS Code: G9344
Short Description: Sysrsn no dicom srch
Long Description: 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)

HCPCS Code: G9345
Short Description: Follow up pulm nod
Long Description: 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

HCPCS Code: G9346
Short Description: No follow up pulm nod
Long Description: Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

HCPCS Code: G9347
Short Description: No follow up pulm nod norsn
Long Description: Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given

HCPCS Code: G9348
Short Description: Docrsn no sinus ct dx
Long Description: Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons (eg, persons with sinusitis symptoms lasting at least 7 to 10 days, antibiotic resistance, immunocompromised, recurrent sinusitis, acute frontal sinusitis, acute sphenoid sinusitis, periorbital cellulitis, or other medical)

HCPCS Code: G9349
Short Description: Doc sinus ct 28d
Long Description: Documentation of a ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis

HCPCS Code: G9350
Short Description: No doc sinus ct 28d or dx
Long Description: Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis

HCPCS Code: G9351
Short Description: Doc >1 sinus ct w 90d dx
Long Description: More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis

HCPCS Code: G9352
Short Description: Not >1 sinus ct w 90d dx
Long Description: More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given

HCPCS Code: G9353
Short Description: Medrsn >1 sinus ct w 90d dx
Long Description: 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)

HCPCS Code: G9354
Short Description: 1 or no ct sinus w/in 90d dx
Long Description: One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis

HCPCS Code: G9355
Short Description: No early ind/delivery
Long Description: Elective delivery or early induction not performed

HCPCS Code: G9356
Short Description: Early ind/delivery
Long Description: Elective delivery or early induction performed

HCPCS Code: G9357
Short Description: Pp eval/edu perf
Long Description: Post-partum screenings, evaluations and education performed

HCPCS Code: G9358
Short Description: Pp eval/edu not perf
Long Description: Post-partum screenings, evaluations and education not performed

HCPCS Code: G9359
Short Description: Doc of neg or man pos tb scn
Long Description: Documentation of negative or managed positive tb screen with further evidence that tb is not active

HCPCS Code: G9360
Short Description: No doc of neg or man pos tb
Long Description: No documentation of negative or managed positive tb screen

HCPCS Code: G9361
Short Description: Med ind for induction
Long Description: Medical indication for induction (documentation of reason(s) for elective delivery or early induction (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes-premature, prolonged maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, malposition and malpresentation of fetus, late pregnancy, prior uterine surgery, or participation in clinical trial))

HCPCS Code: G9362
Short Description: Mac or pnb w/o genanes >60m
Long Description: Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record

HCPCS Code: G9363
Short Description: Mac or pnb w/o genanes <60m
Long Description: Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record

HCPCS Code: G9364
Short Description: Sinus caus bac inx
Long Description: Sinusitis caused by, or presumed to be caused by, bacterial infection

HCPCS Code: G9365
Short Description: 1high risk med ord
Long Description: One high-risk medication ordered

HCPCS Code: G9366
Short Description: 1high risk no ord
Long Description: One high-risk medication not ordered

HCPCS Code: G9367
Short Description: 2high risk med ord
Long Description: At least two different high-risk medications ordered

HCPCS Code: G9368
Short Description: 2high risk no ord
Long Description: At least two different high-risk medications not ordered

HCPCS Code: G9369
Short Description: Fill 2 rx antipsych
Long Description: Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater

HCPCS Code: G9370
Short Description: Not fill 2 rx antipsych
Long Description: Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater

HCPCS Code: G9376
Short Description: Contd ret attach at 6mth f/u
Long Description: Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery

HCPCS Code: G9377
Short Description: No ret attach after 6mt
Long Description: Patient did not have the retina attached after 6 months following only one surgery

HCPCS Code: G9378
Short Description: Contd ret attach f/u vis
Long Description: Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)

HCPCS Code: G9379
Short Description: No acheive flat ret 6mth
Long Description: Patient did not achieve flat retinas six months post surgery

HCPCS Code: G9380
Short Description: Off assis eol iss
Long Description: Patient offered assistance with end of life issues during the measurement period

HCPCS Code: G9381
Short Description: Doc med reas no offer eol
Long Description: Documentation of medical reason(s) for not offering assistance with end of life issues (eg, patient in hospice and in terminal phase) during the measurement period

HCPCS Code: G9382
Short Description: No off assis eol
Long Description: Patient not offered assistance with end of life issues during the measurement period

HCPCS Code: G9383
Short Description: Recd scrn hcv infec
Long Description: Patient received screening for hcv infection within the 12 month reporting period

HCPCS Code: G9384
Short Description: Doc med reas no ann srn hcv
Long Description: 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)

HCPCS Code: G9385
Short Description: Doc pt reas not rec hcv srn
Long Description: Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)

HCPCS Code: G9386
Short Description: Scrn hcv infec not recd
Long Description: Screening for hcv infection not received within the 12 month reporting period, reason not given

HCPCS Code: G9389
Short Description: Unpln rup post cap
Long Description: Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery

HCPCS Code: G9390
Short Description: No unpln rup post cap
Long Description: No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery

HCPCS Code: G9391
Short Description: Achv refrac +1d
Long Description: Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit

HCPCS Code: G9392
Short Description: Not achv refrac +1d
Long Description: Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit

HCPCS Code: G9393
Short Description: Ini phq9 >9 remiss <5
Long Description: 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

HCPCS Code: G9394
Short Description: Dx bipol, death, nhres, hosp
Long Description: 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

HCPCS Code: G9395
Short Description: Ini phq9 >9 no remiss >=5
Long Description: 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

HCPCS Code: G9396
Short Description: Ini phq9 >9 not assess
Long Description: Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)

HCPCS Code: G9399
Short Description: Doc disc tx choices
Long Description: Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment

HCPCS Code: G9400
Short Description: Doc reas no disc tx opt
Long Description: Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons

HCPCS Code: G9401
Short Description: No disc tx choices
Long Description: No documentation of a discussion in the patient record of a discussion between the physician or other qualfied 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

HCPCS Code: G9402
Short Description: Recd f/u w/in 30d disch
Long Description: Patient received follow-up on the date of discharge or within 30 days after discharge

HCPCS Code: G9403
Short Description: Doc reas no 30 day f/u
Long Description: 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)

HCPCS Code: G9404
Short Description: No 30 day f/u
Long Description: Patient did not receive follow-up on the date of discharge or within 30 days after discharge

HCPCS Code: G9405
Short Description: Recd f/u w/in 7d disch
Long Description: Patient received follow-up within 7 days from discharge

HCPCS Code: G9406
Short Description: Doc reas no 7d f/u
Long Description: 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)

HCPCS Code: G9407
Short Description: No 7d f/u
Long Description: Patient did not receive follow-up on or within 7 days after discharge

HCPCS Code: G9408
Short Description: Card tamp w/in 30d
Long Description: Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days

HCPCS Code: G9409
Short Description: No card tamp e/in 30d
Long Description: Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days

HCPCS Code: G9410
Short Description: Admit w/in 180d req remov
Long Description: Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

HCPCS Code: G9411
Short Description: No admit w/in 180d req remov
Long Description: Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

HCPCS Code: G9412
Short Description: Admit w/in 180d req surg rev
Long Description: Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

HCPCS Code: G9413
Short Description: No admit req surg rev
Long Description: Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

HCPCS Code: G9414
Short Description: 1dose menig vac btwn 11 & 13
Long Description: Patient had one dose of meningococcal vaccine on or between the patient's 11th and 13th birthdays

HCPCS Code: G9415
Short Description: No 1dose meni vac btwn 11&13
Long Description: Patient did not have one dose of meningococcal vaccine on or between the patient's 11th and 13th birthdays

HCPCS Code: G9416
Short Description: Tdap or td or 1tet/dipth
Long Description: Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) or one tetanus, diphtheria toxoids vaccine (td) on or between the patient's 10th and 13th birthdays or one tetanus and one diptheria vaccine on or between the patient's 10th and 13th birthdays

HCPCS Code: G9417
Short Description: No tdap or td or 1tet/dipth
Long Description: Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) or one tetanus, diphtheria toxoids vaccine (td) on or between the patient's 10th and 13th birthdays or one tetanus and one diptheria vaccine on or between the patient's 10th and 13th birthdays

HCPCS Code: G9418
Short Description: Lungcx bx rpt docs class
Long Description: Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

HCPCS Code: G9419
Short Description: Med reas not incl histo type
Long Description: Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons)

HCPCS Code: G9420
Short Description: Spec site no lung
Long Description: Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer

HCPCS Code: G9421
Short Description: Lung cx bx rpt no doc class
Long Description: Primary 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

HCPCS Code: G9422
Short Description: Rpt doc class histo type
Long Description: Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)

HCPCS Code: G9423
Short Description: Med reas rpt no histo type
Long Description: 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)

HCPCS Code: G9424
Short Description: Site no lung or lung cx
Long Description: Specimen site other than anatomic location of lung or classified as nsclc-nos

HCPCS Code: G9425
Short Description: Spec rpt no doc class histo
Long Description: Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma)

HCPCS Code: G9426
Short Description: Impr med time edarr pain med
Long Description: Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients

HCPCS Code: G9427
Short Description: No impro med time pain med
Long Description: Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients

HCPCS Code: G9428
Short Description: Rpt pt cat and pt1
Long Description: Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

HCPCS Code: G9429
Short Description: Doc med reas no pt cat
Long Description: Documentation of medical reason(s) for not including 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)

HCPCS Code: G9430
Short Description: Spec site no cutaneous
Long Description: Specimen site other than anatomic cutaneous location

HCPCS Code: G9431
Short Description: No pt cat and pt1
Long Description: Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

HCPCS Code: G9432
Short Description: Asth controlled
Long Description: Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented

HCPCS Code: G9433
Short Description: Death, nhres, hospice
Long Description: Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period

HCPCS Code: G9434
Short Description: Asth not controlled
Long Description: Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given

HCPCS Code: G9435
Short Description: Asp presc disch
Long Description: Aspirin prescribed at discharge

HCPCS Code: G9436
Short Description: Asp not presc doc reas
Long Description: Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)

HCPCS Code: G9437
Short Description: Asp not presc disch
Long Description: Aspirin not prescribed at discharge

HCPCS Code: G9438
Short Description: P2y inhib presc
Long Description: P2y inhibitor prescribed at discharge

HCPCS Code: G9439
Short Description: P2y inhib not presc doc reas
Long Description: P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)

HCPCS Code: G9440
Short Description: P2y inhib not presc
Long Description: P2y inhibitor not prescribed at discharge

HCPCS Code: G9441
Short Description: Statin presc disch
Long Description: Statin prescribed at discharge

HCPCS Code: G9442
Short Description: Statin not presc doc reas
Long Description: Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)

HCPCS Code: G9443
Short Description: Statin not presc disch
Long Description: Statin not prescribed at discharge

HCPCS Code: G9448
Short Description: Born 1945-1965
Long Description: Patients who were born in the years 1945?1965

HCPCS Code: G9449
Short Description: Hx bld transf b/f 1992
Long Description: History of receiving blood transfusions prior to 1992

HCPCS Code: G9450
Short Description: Hx injec drug use
Long Description: History of injection drug use

HCPCS Code: G9451
Short Description: 1x scrn hcv infect
Long Description: Patient received one-time screening for hcv infection

HCPCS Code: G9452
Short Description: Doc med reas no scrn hcv
Long Description: Documentation of medical reason(s) for not receiving one-time screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [ie, ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)

HCPCS Code: G9453
Short Description: Pt reas no hcv infect
Long Description: Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)

HCPCS Code: G9454
Short Description: No hcv infect srn
Long Description: One-time screening for hcv infection not received within 12 month reporting period and no documentation of prior screening for hcv infection, reason not given

HCPCS Code: G9455
Short Description: Abd imag w/us, ct or mri
Long Description: Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc

HCPCS Code: G9456
Short Description: Doc med pt reas no hcc scrn
Long Description: 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)

HCPCS Code: G9457
Short Description: No abd imag w/o reason
Long Description: Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the reporting period

HCPCS Code: G9458
Short Description: Tob user recd cess interv
Long Description: 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

HCPCS Code: G9459
Short Description: Tob non-user
Long Description: Currently a tobacco non-user

HCPCS Code: G9460
Short Description: No tob assess or cess inter
Long Description: Tobacco assessment or tobacco cessation intervention not performed, reason not given

HCPCS Code: G9463
Short Description: Sinusitis intent
Long Description: I intend to report the sinusitis measures group

HCPCS Code: G9464
Short Description: Sinusitis comp
Long Description: All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient

HCPCS Code: G9465
Short Description: Aoe intent
Long Description: I intend to report the acute otitis externa (aoe) measures group

HCPCS Code: G9466
Short Description: Aoe comp
Long Description: All quality actions for the applicable measures in the aoe measures group have been performed for this patient

HCPCS Code: G9467
Short Description: Recd cortico >=10mg/day >60d
Long Description: Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600mg prednisone or greater for all fills within the last twelve months

HCPCS Code: G9468
Short Description: No recd cortico>=10mg/d >60d
Long Description: 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

HCPCS Code: G9469
Short Description: Rec cortico>60d or 1rx 600mg
Long Description: Patients 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

HCPCS Code: G9470
Short Description: No rec cortico>60d 1rx 600mg
Long Description: 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

HCPCS Code: G9471
Short Description: W/in 2yr dxa not order
Long Description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented

HCPCS Code: G9472
Short Description: No dxa no med hx no rv sx
Long Description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed

HCPCS Code: G9473
Short Description: Chap services at hospice
Long Description: Services performed by chaplain in the hospice setting, each 15 minutes

HCPCS Code: G9474
Short Description: Diet counsel at hospice
Long Description: Services performed by dietary counselor in the hospice setting, each 15 minutes

HCPCS Code: G9475
Short Description: Other counselor at hospice
Long Description: Services performed by other counselor in the hospice setting, each 15 minutes

HCPCS Code: G9476
Short Description: Volun service at hospice
Long Description: Services performed by volunteer in the hospice setting, each 15 minutes

HCPCS Code: G9477
Short Description: Care coord at hospice
Long Description: Services performed by care coordinator in the hospice setting, each 15 minutes

HCPCS Code: G9478
Short Description: Othe therapist at hospice
Long Description: Services performed by other qualified therapist in the hospice setting, each 15 minutes

HCPCS Code: G9479
Short Description: Pharmacist at hospice
Long Description: Services performed by qualified pharmacist in the hospice setting, each 15 minutes

HCPCS Code: G9480
Short Description: Admission to mccm
Long Description: Admission to medicare care choice model program (mccm)

HCPCS Code: G9496
Short Description: Doc rsn no adeno/neopl detec
Long Description: Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma

HCPCS Code: G9497
Short Description: Preop anes or proxy b/4 surg
Long Description: Seen pre-operatively by anesthesiologist or proxy prior to the day of surgery

HCPCS Code: G9498
Short Description: Abx reg prescribed
Long Description: Antibiotic regimen prescribed

HCPCS Code: G9499
Short Description: No start/rec antvir tx hep c
Long Description: Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period

HCPCS Code: G9500
Short Description: Rad exp time w/fluor doc
Long Description: Radiation exposure indices, exposure time or number of fluorographic images in final report for procedures using fluoroscopy, documented

HCPCS Code: G9501
Short Description: Rad exp time w/o fluor doc
Long Description: Radiation exposure indices, exposure time or number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not given

HCPCS Code: G9502
Short Description: Med reas no perf foot exam
Long Description: 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)

HCPCS Code: G9503
Short Description: Pt tk tams hcl
Long Description: Patient taking tamsulosin hydrochloride

HCPCS Code: G9504
Short Description: Doc reas no hbv status
Long Description: Documented reason for not assessing hepatitis b virus (hbv) status (e.g. patient not receiving a first course of anti-tnf therapy, patient declined) within one year prior to first course of anti-tnf therapy

HCPCS Code: G9505
Short Description: Abx pres w/in 10 dys of symp
Long Description: Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason

HCPCS Code: G9506
Short Description: Bio imm resp mod presc
Long Description: Biologic immune response modifier prescribed

HCPCS Code: G9507
Short Description: Doc reas on statin or contra
Long Description: 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)

HCPCS Code: G9508
Short Description: Doc pt not on statin
Long Description: Documentation that the patient is not on a statin medication

HCPCS Code: G9509
Short Description: Remis 12m phq-9 score <5
Long Description: Remission at twelve months as demonstrated by a twelve month (+/-30 days) phq-9 score of less than 5

HCPCS Code: G9510
Short Description: Remis 12m not phq-9 score <5
Long Description: Remission at twelve months not demonstrated by a twelve month (+/-30 days) phq-9 score of less than five; either phq-9 score was not assessed or is greater than or equal to 5

HCPCS Code: G9511
Short Description: Phq-9 >9 during 12m time
Long Description: Index date phq-9 score greater than 9 documented during the twelve month denominator identification period

HCPCS Code: G9512
Short Description: Indiv pdc > 0.8
Long Description: Individual had a pdc of 0.8 or greater

HCPCS Code: G9513
Short Description: Indiv pdc not > 0.8
Long Description: Individual did not have a pdc of 0.8 or greater

HCPCS Code: G9514
Short Description: Req ret or w/in 90d of surg
Long Description: Patient required a return to the operating room within 90 days of surgery

HCPCS Code: G9515
Short Description: No reas, no ret or w/in 90d
Long Description: Patient did not require a return to the operating room within 90 days of surgery

HCPCS Code: G9516
Short Description: Impr vis acuit w/in 90d
Long Description: Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery

HCPCS Code: G9517
Short Description: No impr vis acuit w/in 90d
Long Description: Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given

HCPCS Code: G9518
Short Description: Doc active inj drug use
Long Description: Documentation of active injection drug use

HCPCS Code: G9519
Short Description: Final refract +/- 1.0 in 90d
Long Description: Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

HCPCS Code: G9520
Short Description: Refract not +/- 1.0 w/in 90d
Long Description: Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery, reason not given

HCPCS Code: G9521
Short Description: Er and ip hosp <2 in 12 mos
Long Description: Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months

HCPCS Code: G9522
Short Description: Er/ip hosp =/>2 in 12 mos
Long Description: 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

HCPCS Code: G9523
Short Description: D/c hemo or perit dialysis
Long Description: Patient discontinued from hemodialysis or peritoneal dialysis

HCPCS Code: G9524
Short Description: Refer to hospice
Long Description: Patient was referred to hospice care

HCPCS Code: G9525
Short Description: Doc pt reas no hospice refer
Long Description: Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)

HCPCS Code: G9526
Short Description: No reason, no refer hospice
Long Description: Patient was not referred to hospice care, reason not given

HCPCS Code: G9529
Short Description: Minor blunt trauma w/head ct
Long Description: Patient with minor blunt head trauma had an appropriate indication(s) for a head ct

HCPCS Code: G9530
Short Description: Min hd traum gcs=15 w/ct ed
Long Description: Patient presented within 24 hours of a minor blunt head trauma with a gcs score of 15 and had a head ct ordered for trauma by an emergency care provider

HCPCS Code: G9531
Short Description: Indic for head ct valid
Long Description: Patient has a valid reason for a head ct for trauma being ordered, regardless of indications (i.e., ventricular shunt, brain tumor, multisystem trauma, pregnancy, or currently taking an antiplatelet medication including: asa/dipyridamole, clopidogrel, prasugrel, ticlopidine, ticagrelor or cilstazol)

HCPCS Code: G9532
Short Description: Inj >24 hr in ed gcs <15
Long Description: Patient's head injury occurred greater than 24 hours before presentation to the emergency department, or has a gcs score less than 15, or had a head ct for trauma ordered by someone other than an emergency care provider, or was ordered for a reason other than trauma

HCPCS Code: G9533
Short Description: Indic for head ct not valid
Long Description: Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct

HCPCS Code: G9534
Short Description: Adv brain image not ordered
Long Description: Advanced brain imaging (cta, ct, mra or mri) was not ordered

HCPCS Code: G9535
Short Description: Normal neuro exam
Long Description: Patients with a normal neurological examination

HCPCS Code: G9536
Short Description: Doc med reas adv brain image
Long Description: Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)

HCPCS Code: G9537
Short Description: Doc system reas adv imaging
Long Description: Documentation of system reason(s) for ordering an advanced brain imaging study (i.e., needed as part of a clinical trial; other clinician ordered the study)

HCPCS Code: G9538
Short Description: Adv brain image ordered
Long Description: Advanced brain imaging (cta, ct, mra or mri) was ordered

HCPCS Code: G9539
Short Description: Intent pot remv time placemt
Long Description: Intent for potential removal at time of placement

HCPCS Code: G9540
Short Description: Pt alive 3 mos post proc
Long Description: Patient alive 3 months post procedure

HCPCS Code: G9541
Short Description: Filter gone aft 3mos placmt
Long Description: Filter removed within 3 months of placement

HCPCS Code: G9542
Short Description: Doc reass appr remo filt 3ms
Long Description: Documented re-assessment for the appropriateness of filter removal within 3 months of placement

HCPCS Code: G9543
Short Description: Doc 2x re-assess filt remov
Long Description: 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

HCPCS Code: G9544
Short Description: No filt remov w/in 3mos plcm
Long Description: 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

HCPCS Code: G9547
Short Description: Incid ct liver/kid/adre fdg
Long Description: Incidental ct finding: liver lesion = 0.5 cm, cystic kidney lesion < 1.0 cm or adrenal lesion = 1.0 cm

HCPCS Code: G9548
Short Description: Abd imag and followup rec
Long Description: Final reports for abdominal imaging studies with follow-up imaging recommended

HCPCS Code: G9549
Short Description: Doc med reas no follow imag
Long Description: Documentation of medical reason(s) that follow-up imaging is not indicated (e.g., patient has a known malignancy that can metastasize, other medical reason(s)

HCPCS Code: G9550
Short Description: Abd imag and followup no rec
Long Description: Final reports for abdominal imaging studies with follow-up imaging not recommended

HCPCS Code: G9551
Short Description: Abd imag w/o liv/kid/adr les
Long Description: Final reports for abdominal imaging studies without a liver lesion < 0.5 cm, cystic kidney lesion < 1.0 cm or adrenal lesion < 1.0 cm noted

HCPCS Code: G9552
Short Description: Inc thyr node <1.0 in rpt
Long Description: Incidental thyroid nodule < 1.0 cm noted in report

HCPCS Code: G9553
Short Description: Prior thyroid dise dx
Long Description: Prior thyroid disease diagnosis

HCPCS Code: G9554
Short Description: Ct/mri chest/neck follup rec
Long Description: Final reports for ct or mri of the chest or neck or ultrasound of the neck with follow-up imaging recommended

HCPCS Code: G9555
Short Description: Doc med reas no follow imag
Long Description: Documentation of medical reason(s) for not including documentation that follow up imaging is not needed (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))

HCPCS Code: G9556
Short Description: Ct/mri chest follup not rec
Long Description: Final reports for ct or mri of the chest or neck or ultrasound of the neck with follow-up imaging not recommended

HCPCS Code: G9557
Short Description: Ct/mri chest/neck no thy nod
Long Description: Final reports for ct or mri studies of the chest or neck or ultrasound of the neck without a thyroid nodule < 1.0 cm noted

HCPCS Code: G9558
Short Description: Tx beta-lactam abx therapy
Long Description: Patient treated with a beta-lactam antibiotic as definitive therapy

HCPCS Code: G9559
Short Description: Doc med reas no abx therapy
Long Description: Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta -lactam antibiotics)

HCPCS Code: G9560
Short Description: No beta-lactam abx ther, rng
Long Description: Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given

HCPCS Code: G9561
Short Description: Presc opiates >6 wks
Long Description: Patients prescribed opiates for longer than six weeks

HCPCS Code: G9562
Short Description: Foll-up eval q3mo opiod tx
Long Description: Patients who had a follow-up evaluation conducted at least every three months during opioid therapy

HCPCS Code: G9563
Short Description: No f/u eval q3mo opiod tx
Long Description: Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy

HCPCS Code: G9572
Short Description: Phq-scr >9 doc in 12m time
Long Description: Index date phq-score greater than 9 documented during the twelve month denominator identification period

HCPCS Code: G9573
Short Description: Remis 6m w/6mos phq-9 <5
Long Description: Remission at six months as demonstrated by a six month (+/-30 days) phq-9 score of less than five

HCPCS Code: G9574
Short Description: Remis 6m w/o 6mos phq-9 <5
Long Description: Remission at six months not demonstrated by a six month (+/-30 days) phq-9 score of less than five. either phq-9 score was not assessed or is greater than or equal to five

HCPCS Code: G9577
Short Description: Presc opiates >6 wks
Long Description: Patients prescribed opiates for longer than six weeks

HCPCS Code: G9578
Short Description: Doc opioid tx 1x during ther
Long Description: Documentation of signed opioid treatment agreement at least once during opioid therapy

HCPCS Code: G9579
Short Description: No doc opioid tx 1x at ther
Long Description: No documentation of signed an opioid treatment agreement at least once during opioid therapy

HCPCS Code: G9580
Short Description: Door to punc time <2hrs
Long Description: Door to puncture time of less than 2 hours

HCPCS Code: G9581
Short Description: Md doc, door to punc tm >2hr
Long Description: Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)

HCPCS Code: G9582
Short Description: Door to punc time >2hr, nrg
Long Description: Door to puncture time of greater than 2 hours, no reason given

HCPCS Code: G9583
Short Description: Presc opiates >6 wks
Long Description: Patients prescribed opiates for longer than six weeks

HCPCS Code: G9584
Short Description: Eval opioid use instr/pt int
Long Description: Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soaap-r) or patient interviewed at least once during opioid therapy

HCPCS Code: G9585
Short Description: No eval opi use instr/intv
Long Description: Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soaap-r) or patient not interviewed at least once during opioid therapy

HCPCS Code: G9593
Short Description: Low pecarn ped head trauma
Long Description: Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules

HCPCS Code: G9594
Short Description: Gsc >15 & hd ct by ed md
Long Description: Patient presented within 24 hours of a minor blunt head trauma with a gcs score of 15 and had a head ct ordered for trauma by an emergency care provider

HCPCS Code: G9595
Short Description: Val rsn hd ct ord reg indic
Long Description: Patient has a valid reason for a head ct for trauma being ordered, regardless of indications (ie, ventricular shunt, brain tumor, coagulopathy, including thrombocytopenia)

HCPCS Code: G9596
Short Description: Hd inj >24h/gcs >15/no res
Long Description: Pediatric patient's head injury occurred greater than 24 hours before presentation to the emergency department, or has a gcs score less than 15, or had a head ct for trauma ordered by someone other than an emergency care provider, or was ordered for a reason other than trauma

HCPCS Code: G9597
Short Description: No low pecarn ped head traum
Long Description: Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules

HCPCS Code: G9598
Short Description: Aor ane 5.5-5.9 cm max diam
Long Description: Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct

HCPCS Code: G9599
Short Description: Aor ane >=6.0 cm max diam
Long Description: Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct

HCPCS Code: G9600
Short Description: Symp aaa urgent repair
Long Description: Symptomatic aaas that required urgent/emergent (non-elective) repair

HCPCS Code: G9601
Short Description: Pt dchg home post op day 7
Long Description: Patient discharge to home no later than post-operative day #7

HCPCS Code: G9602
Short Description: Pt no dchg home postop day 7
Long Description: Patient not discharged to home by post-operative day #7

HCPCS Code: G9603
Short Description: Pt surv improv bsline tx
Long Description: Patient survey score improved from baseline following treatment

HCPCS Code: G9604
Short Description: Pt surv results not avail
Long Description: Patient survey results not available

HCPCS Code: G9605
Short Description: Surv score no improv w/tx
Long Description: Patient survey score did not improve from baseline following treatment

HCPCS Code: G9606
Short Description: Intraop cyst eval trac inj
Long Description: Intraoperative cystoscopy performed to evaluate for lower tract injury

HCPCS Code: G9607
Short Description: Pt not elig
Long Description: Patient is not eligible (e.g., patient death during procedure, absent urethra or an otherwise inaccessible bladder)

HCPCS Code: G9608
Short Description: Intraop cyst eval not done
Long Description: Intraoperative cystoscopy not performed to evaluate for lower tract injury

HCPCS Code: G9609
Short Description: Doc order anti-plat or p2y12
Long Description: Documentation of an order for anti-platelet agents or p2y12 antagonists

HCPCS Code: G9610
Short Description: Doc md rsn no antipla/p2y12
Long Description: Documentation of medical reason(s) for not ordering anti-platelet agents or p2y12 antagonists (e.g., patients with known intolerance to anti-platelet agents such as aspirin or aspirin-like agents, or p2y12 antagonists, or those on or other intravenous anti-coagulants; patients with active bleeding or undergoing urgent or emergent operations or endarterectomy combined with cardiac surgery, other medical reason(s))

HCPCS Code: G9611
Short Description: No antipla/p2y12 ord, rs nos
Long Description: Order for anti-platelet agents or p2y12 antagonists was not documented, reason not otherwise specified

HCPCS Code: G9612
Short Description: Pho doc >1 cecal ldmk com ex
Long Description: Photodocumentation of one or more cecal landmarks to establish a complete examination

HCPCS Code: G9613
Short Description: Doc post surg anatomy
Long Description: Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)

HCPCS Code: G9614
Short Description: No photodoc cecal ldmk exam
Long Description: No photodocumentation of cecal landmarks to establish a complete examination

HCPCS Code: G9615
Short Description: Pre-op asst doc
Long Description: Preoperative assessment documented

HCPCS Code: G9616
Short Description: Doc rsn no preop assmt
Long Description: Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)

HCPCS Code: G9617
Short Description: Pre-op asst not doc, rng
Long Description: Preoperative assessment not documented, reason not given

HCPCS Code: G9618
Short Description: Doc scr uter mal or us/samp
Long Description: Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind

HCPCS Code: G9619
Short Description: Doc rsn no scr uter malig
Long Description: Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)

HCPCS Code: G9620
Short Description: No scr utr malig/us/samp rng
Long Description: Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given

HCPCS Code: G9621
Short Description: Scr unheal etoh w/counsel
Long Description: Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling

HCPCS Code: G9622
Short Description: No unheal etoh user
Long Description: Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method

HCPCS Code: G9623
Short Description: Doc med rsn no scr etoh use
Long Description: Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)

HCPCS Code: G9624
Short Description: No etoh scr/no counc/nrg
Long Description: Patient not screened for unhealthy alcohol screening using a systematic screening method or patient did not receive brief counseling, reason not given

HCPCS Code: G9625
Short Description: Bld inj at surg/1mos post
Long Description: Patient sustained bladder injury at the time of surgery or subsequently up to 1 month post-surgery

HCPCS Code: G9626
Short Description: Pt not elig
Long Description: Patient is not eligible (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder neoplasia or otherwise to treat a bladder specific problem, patient death from other causes, etc.)

HCPCS Code: G9627
Short Description: No bld inj at surg/1mos post
Long Description: Patient did not sustained bladder injury at the time of surgery or subsequently up to 1 month post-surgery

HCPCS Code: G9628
Short Description: Vis inj at surg/1mos post
Long Description: Patient sustained major viscus injury at the time of surgery or subsequently up to 1 month post-surgery

HCPCS Code: G9629
Short Description: Pt not elig
Long Description: Patient is not eligible (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder neoplasia or otherwise to treat a bladder specific problem, patient death from other causes, etc.)

HCPCS Code: G9630
Short Description: No vis inj at surg/1mos post
Long Description: Patient did not sustain major viscus injury at the time of surgery or subsequently up to 1 month post-surgery

HCPCS Code: G9631
Short Description: Urtr inj at surg/1mos post
Long Description: Patient sustained ureter injury at the time of surgery or discovered subsequently up to 1 month post-surgery

HCPCS Code: G9632
Short Description: Pt not elig
Long Description: Patient is not eligible (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder neoplasia or otherwise to treat a bladder specific problem, patient death from other causes, etc.)

HCPCS Code: G9633
Short Description: No urtr inj at surg/1ms post
Long Description: Patient did not sustain ureter injury at the time of surgery or subsequently up to 1 month post-surgery

HCPCS Code: G9634
Short Description: Qual life tool 2x same/impr
Long Description: Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved

HCPCS Code: G9635
Short Description: No doc rsn do qual life assm
Long Description: Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)

HCPCS Code: G9636
Short Description: No life asst 2x same/decr
Long Description: Health-related quality of life not assessed with tool during at least two visits or quality of life score declined

HCPCS Code: G9637
Short Description: Doc >1 dose reduc tech
Long Description: 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)

HCPCS Code: G9638
Short Description: No doc >1 dose reduc tech
Long Description: 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)

HCPCS Code: G9639
Short Description: Amp no reqd in48h ieler proc
Long Description: Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure

HCPCS Code: G9640
Short Description: Doc plan hybrid/stage proc
Long Description: Documentation of planned hybrid or staged procedure

HCPCS Code: G9641
Short Description: Amp reqd w/in 48h ieler proc
Long Description: Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure

HCPCS Code: G9642
Short Description: Current cig smoker
Long Description: Current cigarette smokers

HCPCS Code: G9643
Short Description: Elective surgery
Long Description: Elective surgery

HCPCS Code: G9644
Short Description: No smok b/4 anes day of surg
Long Description: Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure

HCPCS Code: G9645
Short Description: Had smoke b/4 anes day surg
Long Description: Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure

HCPCS Code: G9646
Short Description: Pt w/90d mrs 0-2
Long Description: Patients with 90 day mrs score of 0 to 2

HCPCS Code: G9647
Short Description: No mrs score in 90d followup
Long Description: Patients in whom mrs score could not be obtained at 90 day follow-up

HCPCS Code: G9648
Short Description: Pt w/90d mrs >2
Long Description: Patients with 90 day mrs score greater than 2

HCPCS Code: G9649
Short Description: Psori tool doc w/benchmk
Long Description: Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))

HCPCS Code: G9650
Short Description: Doc pt no ther chg or contra
Long Description: Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi

HCPCS Code: G9651
Short Description: Psori tool doc/no bnchmk met
Long Description: Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 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

HCPCS Code: G9652
Short Description: Pt tx sys bio med psori 6mth
Long Description: Patient has been treated with a systemic or biologic medication for psoriasis for at least six months

HCPCS Code: G9653
Short Description: Pt no tx sys bio rx 6 mths
Long Description: Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months

HCPCS Code: G9654
Short Description: Mon anesth care
Long Description: Monitored anesthesia care (mac)

HCPCS Code: G9655
Short Description: Toc tool incl key elem
Long Description: A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used

HCPCS Code: G9656
Short Description: Pt direct anesth loc to pacu
Long Description: Patient transferred directly from anesthetizing location to pacu

HCPCS Code: G9657
Short Description: Toc dur aneth to icu
Long Description: Transfer of care during an anesthetic or to the intensive care unit

HCPCS Code: G9658
Short Description: Toc tool incl elem not used
Long Description: A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used

HCPCS Code: G9659
Short Description: >85y no hx colo ca/rsn scope
Long Description: Patients greater than 85 years of age who did not have a history of colorectal cancer or 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

HCPCS Code: G9660
Short Description: Doc med rsn scope pt >85y
Long Description: Documentation of medical reason(s) for a colonoscopy performed on a patient greater than 85 years of age (eg., last colonoscopy incomplete, last colonoscopy had inadequate prep, 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)

HCPCS Code: G9661
Short Description: >85y scope othr rsn
Long Description: Patients greater than 85 years of age who received a routine colonoscopy for a reason other than the following: an assessment of signs/symptoms of gi tract illness, and/or the patient is considered high risk, and/or to follow-up on previously diagnoses advance lesions

HCPCS Code: G9662
Short Description: Prior dx/active clin ascvd
Long Description: Previously diagnosed or have an active diagnosis of clinical ascvd

HCPCS Code: G9663
Short Description: Fast/dir ldl = 190 mg/dl
Long Description: Any fasting or direct ldl-c laboratory test result = 190 mg/dl

HCPCS Code: G9664
Short Description: Taking statin or rec'd order
Long Description: Patients who are currently statin therapy users or received an order (prescription) for statin therapy

HCPCS Code: G9665
Short Description: No statin/no order statin
Long Description: Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy

HCPCS Code: G9666
Short Description: Fas/dir ldl 70-189mg/dl mst
Long Description: The highest fasting or direct ldl-c laboratory test result of 70?189 mg/dl in the measurement period or two years prior to the beginning of the measurement period

HCPCS Code: G9667
Short Description: Doc med rsn no stat tx/presc
Long Description: Documentation of medical reason (s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)

HCPCS Code: G9668
Short Description: Doc med rsn no stat tx/presc
Long Description: Documentation of medical reason (s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)

HCPCS Code: G9669
Short Description: Intend rpt mult chr msr grp
Long Description: I intend to report the multiple chronic conditions measures group

HCPCS Code: G9670
Short Description: Qty act mcc mg perf
Long Description: All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient

HCPCS Code: G9671
Short Description: Intend rpt dia retin msr grp
Long Description: I intend to report the diabetic retinopathy measures group

HCPCS Code: G9672
Short Description: Qty act diab retin mg perf
Long Description: All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient

HCPCS Code: G9673
Short Description: Intend rpt card prev msr grp
Long Description: I intend to report the cardiovascular prevention measures group

HCPCS Code: G9674
Short Description: Pt w/clin ascvd dx
Long Description: Patients with clinical ascvd diagnosis

HCPCS Code: G9675
Short Description: Pt w/fast/dir lab ldl-c >190
Long Description: Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl

HCPCS Code: G9676
Short Description: 40-75y w/type 1/2 w/ldl-c rs
Long Description: 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

HCPCS Code: G9677
Short Description: Qty act card prev mg perf
Long Description: All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient