HCPCS 'G' Codes (1547)

Procedures / Professional Services (Temporary Codes)
Code Description
G0008 Administration of influenza virus vaccine
G0009 Administration of pneumococcal vaccine
G0010 Administration of hepatitis b vaccine
G0027 Semen analysis; presence and/or motility of sperm excluding huhner
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0102 Prostate cancer screening; digital rectal examination
G0103 Prostate cancer screening; prostate specific antigen test (psa)
G0104 Colorectal cancer screening; flexible sigmoidoscopy
G0105 Colorectal cancer screening; colonoscopy on individual at high risk
G0106 Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes
G0109 Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
G0117 Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
G0118 Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
G0120 Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
G0122 Colorectal cancer screening; barium enema
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
G0127 Trimming of dystrophic nails, any number
G0128 Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes
G0129 Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)
G0130 Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
G0141 Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
G0143 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
G0144 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
G0147 Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
G0148 Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes
G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes
G0153 Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes
G0154 Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes
Terminated February 29, 2016.
G0155 Services of clinical social worker in home health or hospice settings, each 15 minutes
G0156 Services of home health/hospice aide in home health or hospice settings, each 15 minutes
G0157 Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes
G0158 Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes
G0159 Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes
G0160 Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
G0161 Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes
G0162 Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)
G0163 Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
Terminated December 31, 2016.
G0164 Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
Terminated December 31, 2016.
G0166 External counterpulsation, per treatment session
G0168 Wound closure utilizing tissue adhesive(s) only
G0173 Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session
Terminated December 31, 2014.
G0175 Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present
G0176 Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
G0177 Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per re-certification period
G0180 Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per certification period
G0181 Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
G0182 Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
G0186 Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)
G0202 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
Terminated December 31, 2017.
G0204 Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
Terminated December 31, 2017.
G0206 Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
Terminated December 31, 2017.
G0219 Pet imaging whole body; melanoma for non-covered indications
G0235 Pet imaging, any site, not otherwise specified
G0237 Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
G0238 Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
G0239 Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
G0245 Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education
G0246 Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
G0247 Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
G0248 Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
G0249 Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests
G0250 Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests
G0251 Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment
Terminated December 31, 2014.
G0252 Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
G0255 Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility
G0259 Injection procedure for sacroiliac joint; arthrography
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
G0268 Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
G0269 Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)
G0270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
G0271 Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
G0276 Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial
G0277 Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
G0278 Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to g0204 or g0206)
G0281 Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
G0282 Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
G0288 Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
G0293 Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day
G0294 Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day
G0295 Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
G0297 Low dose ct scan (ldct) for lung cancer screening
G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes
G0300 Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes
G0302 Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
G0303 Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
G0304 Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
G0305 Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
G0306 Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
G0307 Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous
G0329 Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
G0333 Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary
G0337 Hospice evaluation and counseling services, pre-election
G0339 Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
G0340 Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment
G0341 Percutaneous islet cell transplant, includes portal vein catheterization and infusion
G0342 Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion
G0343 Laparotomy for islet cell transplant, includes portal vein catheterization and infusion
G0364 Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
Terminated December 31, 2017.
G0365 Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)
G0372 Physician service required to establish and document the need for a power mobility device
G0378 Hospital observation service, per hour
G0379 Direct admission of patient for hospital observation care
G0380 Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0381 Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0382 Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0383 Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0384 Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0389 Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
Terminated December 31, 2016.
G0390 Trauma response team associated with hospital critical care service
G0396 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
G0397 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes
G0398 Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation
G0400 Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
G0404 Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
G0405 Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
G0406 Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth
G0408 Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth
G0409 Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)
G0410 Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes
G0411 Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes
G0412 Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)
G0414 Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)
G0415 Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)
G0416 Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
G0417 Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens
Terminated December 31, 2014.
G0418 Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens
Terminated December 31, 2014.
G0419 Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens
Terminated December 31, 2014.
G0420 Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
G0421 Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
G0422 Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
G0423 Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
G0424 Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
G0425 Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
G0427 Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
G0428 Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
G0429 Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
G0431 Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
Terminated December 31, 2015.
G0432 Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening
G0433 Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
G0434 Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
Terminated December 31, 2015.
G0435 Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
G0436 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
Terminated September 30, 2016.
G0437 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
Terminated September 30, 2016.
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G0442 Annual alcohol misuse screening, 15 minutes
G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
G0444 Annual depression screening, 15 minutes
G0445 High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
G0447 Face-to-face behavioral counseling for obesity, 15 minutes
G0448 Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing
G0451 Development testing, with interpretation and report, per standardized instrument form
G0452 Molecular pathology procedure; physician interpretation and report
G0453 Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
G0454 Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
G0455 Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
G0456 Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters
Terminated December 31, 2014.
G0457 Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters
Terminated December 31, 2014.
G0458 Low dose rate (ldr) prostate brachytherapy services, composite rate
G0459 Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
G0460 Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment
G0461 Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
Terminated December 31, 2014.
G0462 Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)
Terminated December 31, 2014.
G0463 Hospital outpatient clinic visit for assessment and management of a patient
G0464 Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
Terminated December 31, 2015.
G0466 Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
G0468 Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv
G0469 Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
G0471 Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s)
G0473 Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
G0475 Hiv antigen/antibody, combination assay, screening
G0476 Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test
G0477 Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
Terminated December 31, 2016.
G0478 Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
Terminated December 31, 2016.
G0479 Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service
Terminated December 31, 2016.
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed
G0481 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed
G0482 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed
G0483 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed
G0490 Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)
G0491 Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd
G0492 Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd
G0493 Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0494 Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0495 Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0496 Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0498 Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion
G0499 Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag) followed by a neutralizing confirmatory test for initially reactive results, and antibodies to hbsag (anti-hbs) and hepatitis b core antigen (anti-hbc)
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
G0501 Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
G0502 Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies
Terminated December 31, 2017.
G0503 Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment
Terminated December 31, 2017.
G0504 Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
Terminated December 31, 2017.
G0505 Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
Terminated December 31, 2017.
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
G0507 Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team
Terminated December 31, 2017.
G0508 Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
G0509 Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
G0512 Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
G0513 Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
G0514 Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
G0515 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
G0516 Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
G0517 Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G0518 Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G0659 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes
G0908 Most recent hemoglobin (hgb) level > 12.0 g/dl
Terminated December 31, 2014.
G0909 Hemoglobin level measurement not documented, reason not given
Terminated December 31, 2014.
G0910 Most recent hemoglobin level <= 12.0 g/dl
Terminated December 31, 2014.
G0913 Improvement in visual function achieved within 90 days following cataract surgery
G0914 Patient care survey was not completed by patient
G0915 Improvement in visual function not achieved within 90 days following cataract surgery
G0916 Satisfaction with care achieved within 90 days following cataract surgery
G0917 Patient satisfaction survey was not completed by patient
G0918 Satisfaction with care not achieved within 90 days following cataract surgery
G0919 Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit
Terminated December 31, 2014.
G0920 Type, anatomic location, and activity all documented
Terminated December 31, 2014.
G0921 Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)
Terminated December 31, 2014.
G0922 No documentation of disease type, anatomic location, and activity, reason not given
Terminated December 31, 2014.
G3001 Administration and supply of tositumomab, 450 mg
Terminated December 31, 2016.
G6001 Ultrasonic guidance for placement of radiation therapy fields
G6002 Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy
G6003 Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev
G6004 Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev
G6005 Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev
G6006 Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater
G6007 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev
G6008 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev
G6009 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev
G6010 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater
G6011 Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev
G6012 Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev
G6013 Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev
G6014 Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
G6016 Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session
G6017 Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment
G6018 Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)
Terminated December 31, 2015.
G6019 Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
Terminated December 31, 2015.
G6020 Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
Terminated December 31, 2015.
G6021 Unlisted procedure, intestine
Terminated December 31, 2015.
G6022 Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
Terminated December 31, 2015.
G6023 Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)
Terminated December 31, 2015.
G6024 Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
Terminated December 31, 2015.
G6025 Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)
Terminated December 31, 2015.
G6027 Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed
Terminated December 31, 2015.
G6028 Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)
Terminated December 31, 2015.
G6030 Amitriptyline
Terminated December 31, 2015.
G6031 Benzodiazepines
Terminated December 31, 2015.
G6032 Desipramine
Terminated December 31, 2015.
G6034 Doxepin
Terminated December 31, 2015.
G6035 Gold
Terminated December 31, 2015.
G6036 Assay of imipramine
Terminated December 31, 2015.
G6037 Nortriptyline
Terminated December 31, 2015.
G6038 Salicylate
Terminated December 31, 2015.
G6039 Acetaminophen
Terminated December 31, 2015.
G6040 Alcohol (ethanol); any specimen except breath
Terminated December 31, 2015.
G6041 Alkaloids, urine, quantitative
Terminated December 31, 2015.
G6042 Amphetamine or methamphetamine
Terminated December 31, 2015.
G6043 Barbiturates, not elsewhere specified
Terminated December 31, 2015.
G6044 Cocaine or metabolite
Terminated December 31, 2015.
G6045 Dihydrocodeinone
Terminated December 31, 2015.
G6046 Dihydromorphinone
Terminated December 31, 2015.
G6047 Dihydrotestosterone
Terminated December 31, 2015.
G6048 Dimethadione
Terminated December 31, 2015.
G6049 Epiandrosterone
Terminated December 31, 2015.
G6050 Ethchlorvynol
Terminated December 31, 2015.
G6051 Flurazepam
Terminated December 31, 2015.
G6052 Meprobamate
Terminated December 31, 2015.
G6053 Methadone
Terminated December 31, 2015.
G6054 Methsuximide
Terminated December 31, 2015.
G6055 Nicotine
Terminated December 31, 2015.
G6056 Opiate(s), drug and metabolites, each procedure
Terminated December 31, 2015.
G6057 Phenothiazine
Terminated December 31, 2015.
G6058 Drug confirmation, each procedure
Terminated December 31, 2015.
G8126 Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
Terminated December 31, 2014.
G8127 Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
Terminated December 31, 2014.
G8128 Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure
Terminated December 31, 2014.
G8395 Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
G8396 Left ventricular ejection fraction (lvef) not performed or documented
G8397 Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy
G8398 Dilated macular or fundus exam not performed
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed
G8400 Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given
G8401 Clinician documented that patient was not an eligible candidate for screening
Terminated December 31, 2016.
G8404 Lower extremity neurological exam performed and documented
G8405 Lower extremity neurological exam not performed
G8406 Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure
Terminated December 31, 2014.
G8410 Footwear evaluation performed and documented
G8415 Footwear evaluation was not performed
G8416 Clinician documented that patient was not an eligible candidate for footwear evaluation measure
G8417 Bmi is documented above normal parameters and a follow-up plan is documented
G8418 Bmi is documented below normal parameters and a follow-up plan is documented
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given
G8420 Bmi is documented within normal parameters and no follow-up plan is required
G8421 Bmi not documented and no reason is given
G8422 Bmi not documented, documentation the patient is not eligible for bmi calculation
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given
G8430 Eligible clinician attests to documenting in the medical record the patient is not eligible for a current list of medications being obtained, updated, or reviewed by the eligible clinician
G8431 Screening for depression is documented as being positive and a follow-up plan is documented
G8432 Depression screening not documented, reason not given
G8433 Screening for depression not completed, documented reason
G8442 Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter
G8450 Beta-blocker therapy prescribed
G8451 Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons, or other reasons attributable to the healthcare system)
G8452 Beta-blocker therapy not prescribed
G8458 Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)
Terminated December 31, 2016.
G8460 Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c
Terminated December 31, 2016.
G8461 Patient receiving antiviral treatment for hepatitis c during the measurement period
Terminated December 31, 2016.
G8464 Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined
Terminated December 31, 2014.
G8465 High or very high risk of recurrence of prostate cancer
G8473 Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed
G8474 Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) or (e.g., lack of drug availability, other reasons attributable to the health care system)
G8475 Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given
G8476 Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg
G8477 Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg
G8478 Blood pressure measurement not performed or documented, reason not given
G8482 Influenza immunization administered or previously received
G8483 Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
G8484 Influenza immunization was not administered, reason not given
G8485 I intend to report the diabetes mellitus (dm) measures group
Terminated December 31, 2016.
G8486 I intend to report the preventive care measures group
Terminated December 31, 2016.
G8487 I intend to report the chronic kidney disease (ckd) measures group
Terminated December 31, 2016.
G8489 I intend to report the coronary artery disease (cad) measures group
Terminated December 31, 2016.
G8490 I intend to report the rheumatoid arthritis (ra) measures group
Terminated December 31, 2016.
G8491 I intend to report the hiv/aids measures group
Terminated December 31, 2016.
G8492 I intend to report the perioperative care measures group
Terminated December 31, 2014.
G8493 I intend to report the back pain measures group
Terminated December 31, 2014.
G8494 All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient
Terminated December 31, 2016.
G8495 All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient
Terminated December 31, 2016.
G8496 All quality actions for the applicable measures in the preventive care measures group have been performed for this patient
Terminated December 31, 2016.
G8497 All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient
Terminated December 31, 2016.
G8498 All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient
Terminated December 31, 2016.
G8499 All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient
Terminated December 31, 2016.
G8500 All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient
Terminated December 31, 2016.
G8501 All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient
Terminated December 31, 2014.
G8502 All quality actions for the applicable measures in the back pain measures group have been performed for this patient
Terminated December 31, 2014.
G8506 Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
G8509 Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given
G8510 Screening for depression is documented as negative, a follow-up plan is not required
G8511 Screening for depression documented as positive, follow-up plan not documented, reason not given
G8530 Autogenous av fistula received
Terminated December 31, 2015.
G8531 Clinician documented that patient was not an eligible candidate for autogenous av fistula
Terminated December 31, 2015.
G8532 Clinician documented that patient received vascular access other than autogenous av fistula, reason not given
Terminated December 31, 2015.
G8535 Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter
G8536 No documentation of an elder maltreatment screen, reason not given
G8539 Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documented
G8540 Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter
G8541 Functional outcome assessment using a standardized tool not documented, reason not given
G8542 Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required
G8543 Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given
G8544 I intend to report the coronary artery bypass graft (cabg) measures group
Terminated December 31, 2016.
G8545 I intend to report the hepatitis c measures group
Terminated December 31, 2016.
G8547 I intend to report the ischemic vascular disease (ivd) measures group
Terminated December 31, 2014.
G8548 I intend to report the heart failure (hf) measures group
Terminated December 31, 2016.
G8549 All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient
Terminated December 31, 2016.
G8551 All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient
Terminated December 31, 2016.
G8552 All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient
Terminated December 31, 2014.
G8559 Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
G8560 Patient has a history of active drainage from the ear within the previous 90 days
G8561 Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
G8562 Patient does not have a history of active drainage from the ear within the previous 90 days
G8563 Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
G8564 Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)
G8565 Verification and documentation of sudden or rapidly progressive hearing loss
G8566 Patient is not eligible for the "referral for otologic evaluation for sudden or rapidly progressive hearing loss" measure
G8567 Patient does not have verification and documentation of sudden or rapidly progressive hearing loss
G8568 Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
G8569 Prolonged postoperative intubation (> 24 hrs) required
G8570 Prolonged postoperative intubation (> 24 hrs) not required
G8571 Development of deep sternal wound infection/mediastinitis within 30 days postoperatively
G8572 No deep sternal wound infection/mediastinitis
G8573 Stroke following isolated cabg surgery
G8574 No stroke following isolated cabg surgery
G8575 Developed postoperative renal failure or required dialysis
G8576 No postoperative renal failure/dialysis not required
G8577 Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
G8578 Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
G8579 Antiplatelet medication at discharge
Terminated December 31, 2014.
G8580 Antiplatelet medication contraindicated
Terminated December 31, 2014.
G8581 No antiplatelet medication at discharge
Terminated December 31, 2014.
G8582 Beta-blocker at discharge
Terminated December 31, 2014.
G8583 Beta-blocker contraindicated
Terminated December 31, 2014.
G8584 No beta-blocker at discharge
Terminated December 31, 2014.
G8585 Anti-lipid treatment at discharge
Terminated December 31, 2014.
G8586 Anti-lipid treatment contraindicated
Terminated December 31, 2014.
G8587 No anti-lipid treatment at discharge
Terminated December 31, 2014.
G8593 Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
Terminated December 31, 2014.
G8594 Lipid profile not performed, reason not given
Terminated December 31, 2014.
G8595 Most recent ldl-c < 100 mg/dl
Terminated December 31, 2014.
G8597 Most recent ldl-c >= 100 mg/dl
Terminated December 31, 2014.
G8598 Aspirin or another antiplatelet therapy used
G8599 Aspirin or another antiplatelet therapy not used, reason not given
G8600 Iv t-pa initiated within three hours (<= 180 minutes) of time last known well
G8601 Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinician
G8602 Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not given
G8627 Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)
G8628 Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)
G8629 Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)
Terminated December 31, 2014.
G8630 Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered
Terminated December 31, 2014.
G8631 Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)
Terminated December 31, 2014.
G8632 Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given
Terminated December 31, 2014.
G8633 Pharmacologic therapy (other than minierals/vitamins) for osteoporosis prescribed
G8634 Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
Terminated December 31, 2016.
G8635 Pharmacologic therapy for osteoporosis was not prescribed, reason not given
G8645 I intend to report the asthma measures group
Terminated December 31, 2016.
G8646 All quality actions for the applicable measures in the asthma measures group have been performed for this patient
Terminated December 31, 2016.
G8647 Risk-adjusted functional status change residual score for the knee successfully calculated and the score was equal to zero (0) or greater than zero (>0)
G8648 Risk-adjusted functional status change residual score for the knee successfully calculated and the score was less than zero (<0)
G8649 Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's status survey near discharge, not appropriate
G8650 Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8651 Risk-adjusted functional status change residual score for the hip successfully calculated and the score was equal to zero (0) or greater than zero (>0)
G8652 Risk-adjusted functional status change residual score for the hip successfully calculated and the score was less than zero (<0)
G8653 Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete follow up status survey near discharge, patient not appropriate
G8654 Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8655 Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)
G8656 Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was less than zero (< 0)
G8657 Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
G8658 Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8659 Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
G8660 Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was less than zero (< 0)
G8661 Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
G8662 Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8663 Risk-adjusted functional status change residual score for the shoulder successfully calculated and the score was equal to zero (0) or greater than zero (>0)
G8664 Risk-adjusted functional status change residual score for the shoulder successfully calculated and the score was less than zero (<0)
G8665 Risk-adjusted functional status change residual scores for the shoulder not measured because the patient did not complete foto's functional status survey near discharge, patient not appropriate
G8666 Risk-adjusted functional status change residual scores for the shoulder not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8667 Risk-adjusted functional status change residual score for the elbow, wrist or hand successfully calculated and the score was equal to zero (0) or greater than zero (>0)
G8668 Risk-adjusted functional status change residual score for the elbow, wrist or hand successfully calculated and the score was less than zero (<0)
G8669 Risk-adjusted functional status change residual scores for the elbow, wrist or hand not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
G8670 Risk-adjusted functional status change residual scores for the elbow, wrist or hand not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8671 Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
G8672 Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was less than zero (< 0)
G8673 Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
G8674 Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8682 Lvf testing documented as being performed prior to discharge or in the previous 12 months
Terminated December 31, 2014.
G8683 Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason
Terminated December 31, 2014.
G8685 Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given
Terminated December 31, 2014.
G8694 Left ventricular ejection fraction (lvef) < 40%
G8696 Antithrombotic therapy prescribed at discharge
Terminated December 31, 2017.
G8697 Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))
Terminated December 31, 2017.
G8698 Antithrombotic therapy was not prescribed at discharge, reason not given
Terminated December 31, 2017.
G8699 Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge
Terminated December 31, 2014.
G8700 Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
Terminated December 31, 2014.
G8701 Rehabilitation services were not ordered, reason not otherwise specified
Terminated December 31, 2014.
G8702 Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
Terminated December 31, 2014.
G8703 Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
Terminated December 31, 2014.
G8704 12-lead electrocardiogram (ecg) performed
Terminated December 31, 2014.
G8705 Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)
Terminated December 31, 2014.
G8706 Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)
Terminated December 31, 2014.
G8707 12-lead electrocardiogram (ecg) not performed, reason not given
Terminated December 31, 2014.
G8708 Patient not prescribed or dispensed antibiotic
G8709 Patient prescribed or dispensed antibiotic for documented medical reason(s) (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases (female reproductive organs)), infections of the kidney, cystitis or uti, and acne)
G8710 Patient prescribed or dispensed antibiotic
G8711 Prescribed or dispensed antibiotic
G8712 Antibiotic not prescribed or dispensed
G8713 Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])
Terminated December 31, 2015.
G8714 Hemodialysis treatment performed exactly three times per week for > 90 days
Terminated December 31, 2015.
G8717 Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given
Terminated December 31, 2015.
G8718 Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])
Terminated December 31, 2015.
G8720 Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])
Terminated December 31, 2015.
G8721 Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
G8722 Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)
G8723 Specimen site is other than anatomic location of primary tumor
G8724 Pt category, pn category and histologic grade were not documented in the pathology report, reason not given
G8725 Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)
Terminated December 31, 2016.
G8726 Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
Terminated December 31, 2016.
G8728 Fasting lipid profile not performed, reason not given
Terminated December 31, 2016.
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented
G8731 Pain assessment using a standardized tool is documented as negative, no follow-up plan required
G8732 No documentation of pain assessment, reason not given
G8733 Elder maltreatment screen documented as positive and a follow-up plan is documented
G8734 Elder maltreatment screen documented as negative, no follow-up required
G8735 Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given
G8736 Most current ldl-c <100mg/dl
Terminated December 31, 2014.
G8737 Most current ldl-c >=100mg/dl
Terminated December 31, 2014.
G8738 Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function
Terminated December 31, 2014.
G8739 Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
Terminated December 31, 2014.
G8740 Left ventricular ejection fraction (lvef) not performed or assessed, reason not given
Terminated December 31, 2014.
G8749 Absence of signs of melanoma (cough, dyspnea, tenderness, localized neurologic signs such as weakness, jaundice or any other sign suggesting systemic spread) or absence of symptoms of melanoma (pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma)
G8751 Smoking status and exposure to second hand smoke in the home not assessed, reason not given
Terminated December 31, 2014.
G8752 Most recent systolic blood pressure < 140 mmhg
G8753 Most recent systolic blood pressure >= 140 mmhg
G8754 Most recent diastolic blood pressure < 90 mmhg
G8755 Most recent diastolic blood pressure >= 90 mmhg
G8756 No documentation of blood pressure measurement, reason not given
G8757 All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient
Terminated December 31, 2016.
G8758 All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient
Terminated December 31, 2016.
G8759 All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient
Terminated December 31, 2016.
G8761 All quality actions for the applicable measures in the dementia measures group have been performed for this patient
Terminated December 31, 2016.
G8762 All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient
Terminated December 31, 2016.
G8763 All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient
Terminated December 31, 2014.
G8764 All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient
Terminated December 31, 2014.
G8765 All quality actions for the applicable measures in the cataract measures group have been performed for this patient
Terminated December 31, 2016.
G8767 Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
Terminated December 31, 2014.
G8768 Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8769 Lipid profile not performed, reason not given
Terminated December 31, 2014.
G8770 Urine protein test result documented and reviewed
Terminated December 31, 2014.
G8771 Documentation of diagnosis of chronic kidney disease
Terminated December 31, 2014.
G8772 Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)
Terminated December 31, 2014.
G8773 Urine protein test was not performed, reason not given
Terminated December 31, 2014.
G8774 Serum creatinine test result documented and reviewed
Terminated December 31, 2014.
G8775 Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8776 Serum creatinine test not performed, reason not given
Terminated December 31, 2014.
G8777 Diabetes screening test performed
Terminated December 31, 2014.
G8778 Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8779 Diabetes screening test not performed, reason not given
Terminated December 31, 2014.
G8780 Counseling for diet and physical activity performed
Terminated December 31, 2014.
G8781 Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8782 Counseling for diet and physical activity not performed, reason not given
Terminated December 31, 2014.
G8783 Normal blood pressure reading documented, follow-up not required
G8784 Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)
Terminated December 31, 2016.
G8785 Blood pressure reading not documented, reason not given
G8797 Specimen site other than anatomic location of esophagus
G8798 Specimen site other than anatomic location of prostate
G8806 Performance of trans-abdominal or trans-vaginal ultrasound
G8807 Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ed multiple times within 72 hours, patient has a documented intrauterine pregnancy [iup])
G8808 Trans-abdominal or trans-vaginal ultrasound not performed, reason not given
G8809 Rh-immunoglobulin (rhogam) ordered
G8810 Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)
G8811 Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
G8815 Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
G8816 Statin medication prescribed at discharge
G8817 Statin therapy not prescribed at discharge, reason not given
G8818 Patient discharge to home no later than post-operative day #7
G8825 Patient not discharged to home by post-operative day #7
G8826 Patient discharge to home no later than post-operative day #2 following evar
G8833 Patient not discharged to home by post-operative day #2 following evar
G8834 Patient discharged to home no later than post-operative day #2 following cea
G8838 Patient not discharged to home by post-operative day #2 following cea
G8839 Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness
G8840 Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)
G8841 Sleep apnea symptoms not assessed, reason not given
G8842 Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosis
G8843 Documentation of reason(s) for not measuring an apnea hypopnea index (ahi) or a respiratory disturbance index (rdi) at the time of initial diagnosis (e.g., psychiatric disease, dementia, patient declined, financial, insurance coverage, test ordered but not yet completed)
G8844 Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) not measured at the time of initial diagnosis, reason not given
G8845 Positive airway pressure therapy prescribed
G8846 Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)
G8848 Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)
Terminated December 31, 2016.
G8849 Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)
G8850 Positive airway pressure therapy not prescribed, reason not given
G8851 Objective measurement of adherence to positive airway pressure therapy, documented
G8852 Positive airway pressure therapy prescribed
G8853 Positive airway pressure therapy not prescribed
Terminated December 31, 2016.
G8854 Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn't bring data from continous positive airway pressure [cpap], therapy not yet initiated, not available on machine)
G8855 Objective measurement of adherence to positive airway pressure therapy not performed, reason not given
G8856 Referral to a physician for an otologic evaluation performed
G8857 Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)
G8858 Referral to a physician for an otologic evaluation not performed, reason not given
G8859 Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Terminated December 31, 2014.
G8860 Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Terminated December 31, 2014.
G8861 Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
G8862 Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
Terminated December 31, 2014.
G8863 Patients not assessed for risk of bone loss, reason not given
G8864 Pneumococcal vaccine administered or previously received
G8865 Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
G8866 Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
G8867 Pneumococcal vaccine not administered or previously received, reason not given
G8868 Patients receiving a first course of anti-tnf therapy
Terminated December 31, 2016.
G8869 Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
G8870 Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
Terminated December 31, 2015.
G8871 Patient not receiving a first course of anti-tnf therapy
Terminated December 31, 2015.
G8872 Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8873 Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
G8874 Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8875 Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
G8876 Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)
G8877 Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given
G8878 Sentinel lymph node biopsy procedure performed
G8879 Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
Terminated December 31, 2017.
G8880 Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent)
G8881 Stage of breast cancer is greater than t1n0m0 or t2n0m0
G8882 Sentinel lymph node biopsy procedure not performed, reason not given
G8883 Biopsy results reviewed, communicated, tracked and documented
G8884 Clinician documented reason that patient's biopsy results were not reviewed
G8885 Biopsy results not reviewed, communicated, tracked or documented
G8886 Most recent blood pressure under control
Terminated December 31, 2014.
G8887 Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8888 Most recent blood pressure not under control, results documented and reviewed
Terminated December 31, 2014.
G8889 No documentation of blood pressure measurement, reason not given
Terminated December 31, 2014.
G8890 Most recent ldl-c under control, results documented and reviewed
Terminated December 31, 2014.
G8891 Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8892 Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
Terminated December 31, 2014.
G8893 Most recent ldl-c not under control, results documented and reviewed
Terminated December 31, 2014.
G8894 Ldl-c not performed, reason not given
Terminated December 31, 2014.
G8895 Oral aspirin or other antithrombotic therapy prescribed
Terminated December 31, 2014.
G8896 Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)
Terminated December 31, 2014.
G8897 Oral aspirin or other antithrombotic therapy was not prescribed, reason not given
Terminated December 31, 2014.
G8898 I intend to report the chronic obstructive pulmonary disease (copd) measures group
Terminated December 31, 2016.
G8899 I intend to report the inflammatory bowel disease (ibd) measures group
Terminated December 31, 2016.
G8900 I intend to report the sleep apnea measures group
Terminated December 31, 2016.
G8902 I intend to report the dementia measures group
Terminated December 31, 2016.
G8903 I intend to report the parkinson's disease measures group
Terminated December 31, 2016.
G8904 I intend to report the hypertension (htn) measures group
Terminated December 31, 2014.
G8905 I intend to report the cardiovascular prevention measures group
Terminated December 31, 2014.
G8906 I intend to report the cataract measures group
Terminated December 31, 2016.
G8907 Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility
G8908 Patient documented to have received a burn prior to discharge
G8909 Patient documented not to have received a burn prior to discharge
G8910 Patient documented to have experienced a fall within asc
G8911 Patient documented not to have experienced a fall within ambulatory surgical center
G8912 Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
G8913 Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
G8914 Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc
G8915 Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc
G8916 Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time
G8917 Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time
G8918 Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis
G8923 Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function
G8924 Spirometry test results demonstrate fev1/fvc < 70%, fev < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
G8925 Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms
G8926 Spirometry test not performed or documented, reason not given
G8927 Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer
Terminated December 31, 2016.
G8928 Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
Terminated December 31, 2016.
G8929 Adjuvant chemotherapy not prescribed or previously received, reason not given
Terminated December 31, 2016.
G8930 Assessment of depression severity at the initial evaluation
Terminated December 31, 2014.
G8931 Assessment of depression severity not documented, reason not given
Terminated December 31, 2014.
G8932 Suicide risk assessed at the initial evaluation
Terminated December 31, 2014.
G8933 Suicide risk not assessed at the initial evaluation, reason not given
Terminated December 31, 2014.
G8934 Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function
G8935 Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
G8936 Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons) or (eg, lack of drug availability, other reasons attributable to the health care system)
G8937 Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given
G8938 Bmi is documented as being outside of normal limits, follow-up plan is not documented, documentation the patient is not eligible
G8939 Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter
G8940 Screening for depression documented as positive, a follow-up plan not completed, documented reason
Terminated December 31, 2016.
G8941 Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter
G8942 Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented
G8943 Ldl-c result not present or not within 12 months prior
Terminated December 31, 2014.
G8944 Ajcc melanoma cancer stage 0 through iic melanoma
G8946 Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)
G8947 One or more neuropsychiatric symptoms
Terminated December 31, 2017.
G8948 No neuropsychiatric symptoms
Terminated December 31, 2016.
G8949 Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)
Terminated December 31, 2014.
G8950 Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented
G8951 Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible
Terminated December 31, 2015.
G8952 Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
G8953 All quality actions for the applicable measures in the oncology measures group have been performed for this patient
Terminated December 31, 2016.
G8955 Most recent assessment of adequacy of volume management documented
G8956 Patient receiving maintenance hemodialysis in an outpatient dialysis facility
G8957 Patient not receiving maintenance hemodialysis in an outpatient dialysis facility
Terminated December 31, 2014.
G8958 Assessment of adequacy of volume management not documented, reason not given
G8959 Clinician treating major depressive disorder communicates to clinician treating comorbid condition
G8960 Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given
G8961 Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery
G8962 Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery
G8963 Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years
G8964 Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)
G8965 Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment
G8966 Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment
G8967 Warfarin or another fda approved oral anticoagulant is prescribed
G8968 Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)
G8969 Documentation of patient reason(s) for not prescribing warfarin or another fda-approved oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)
G8970 No risk factors or one moderate risk factor for thromboembolism
G8971 Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
Terminated December 31, 2017.
G8972 One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
Terminated December 31, 2017.
G8973 Most recent hemoglobin (hgb) level < 10 g/dl
G8974 Hemoglobin level measurement not documented, reason not given
G8975 Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)
G8976 Most recent hemoglobin (hgb) level >= 10 g/dl
G8977 I intend to report the oncology measures group
Terminated December 31, 2016.
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
G8981 Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8983 Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
G8984 Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
G8985 Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8986 Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting
G8990 Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals
G8991 Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8992 Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting
G8993 Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
G8994 Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8995 Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
G8996 Swallowing functional limitation, current status at therapy episode outset and at reporting intervals
G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting
G8999 Motor speech functional limitation, current status at therapy episode outset and at reporting intervals
G9001 Coordinated care fee, initial rate
G9002 Coordinated care fee, maintenance rate
G9003 Coordinated care fee, risk adjusted high, initial
G9004 Coordinated care fee, risk adjusted low, initial
G9005 Coordinated care fee, risk adjusted maintenance
G9006 Coordinated care fee, home monitoring
G9007 Coordinated care fee, scheduled team conference
G9008 Coordinated care fee, physician coordinated care oversight services
G9009 Coordinated care fee, risk adjusted maintenance, level 3
G9010 Coordinated care fee, risk adjusted maintenance, level 4
G9011 Coordinated care fee, risk adjusted maintenance, level 5
G9012 Other specified case management service not elsewhere classified
G9013 Esrd demo basic bundle level i
G9014 Esrd demo expanded bundle including venous access and related services
G9016 Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]
G9017 Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
G9018 Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)
G9019 Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)
G9020 Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
G9033 Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)
G9034 Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)
G9035 Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)
G9036 Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)
G9050 Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)
G9051 Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)
G9052 Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
G9053 Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
G9054 Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)
G9055 Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)
G9056 Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)
G9057 Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)
G9058 Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)
G9059 Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)
G9060 Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)
G9061 Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
G9062 Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)
G9063 Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9064 Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9065 Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9066 Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9067 Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9068 Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9069 Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9070 Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9071 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9072 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i, or stage iia-iib; or t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9073 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9074 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9075 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9077 Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t1-t2c and gleason 2-7 and psa < or equal to 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9078 Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9079 Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t3b-t4, any n; any t, n1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9080 Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising psa or failure of psa decline (for use in a medicare-approved demonstration project)
G9083 Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9084 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9085 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9086 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-4, n1-2, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9087 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)
G9088 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive without current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)
G9089 Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9090 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-2, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9091 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t3, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9092 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n1-2, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence or metastases (for use in a medicare-approved demonstration project)
G9093 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9094 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9095 Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9096 Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t1-t3, n0-n1 or nx (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9097 Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9098 Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9099 Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9100 Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r0 resection (with or without neoadjuvant therapy) with no evidence of disease recurrence, progression, or metastases (for use in a medicare-approved demonstration project)
G9101 Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r1 or r2 resection (with or without neoadjuvant therapy) with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9102 Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m0, unresectable with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9103 Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9104 Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9105 Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post r0 resection without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9106 Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; post r1 or r2 resection with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)
G9107 Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; unresectable at diagnosis, m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9108 Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9109 Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t1-t2 and n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9110 Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t3-4 and/or n1-3, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9111 Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)
G9112 Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9113 Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 1) without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9114 Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 2-3); or stage ic (all grades); or stage ii; without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9115 Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage iii-iv; without evidence of progression, recurrence, or metastases (for use in a medicare-approved demonstration project)
G9116 Oncology; disease status; ovarian cancer, limited to epithelial cancer; evidence of disease progression, or recurrence, and/or platinum resistance (for use in a medicare-approved demonstration project)
G9117 Oncology; disease status; ovarian cancer, limited to epithelial cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9123 Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; chronic phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9124 Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; accelerated phase not in hematologic cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9125 Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; blast phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9126 Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)
G9128 Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)
G9129 Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)
G9130 Oncology; disease status; limited to multiple myeloma, systemic disease; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9131 Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)
G9132 Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-refractory/androgen-independent (e.g., rising psa on anti-androgen therapy or post-orchiectomy); clinical metastases (for use in a medicare-approved demonstration project)
G9133 Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)
G9134 Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage i, ii at diagnosis, not relapsed, not refractory (for use in a medicare-approved demonstration project)
G9135 Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage iii, iv, not relapsed, not refractory (for use in a medicare-approved demonstration project)
G9136 Oncology; disease status; non-hodgkin's lymphoma, transformed from original cellular diagnosis to a second cellular classification (for use in a medicare-approved demonstration project)
G9137 Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)
G9138 Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)
G9139 Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; extent of disease unknown, staging in progress, not listed (for use in a medicare-approved demonstration project)
G9140 Frontier extended stay clinic demonstration; for a patient stay in a clinic approved for the cms demonstration project; the following measures should be present: the stay must be equal to or greater than 4 hours; weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration; there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer; payment is made on each period up to 4 hours, after the first 4 hours
G9143 Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)
G9147 Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration
G9148 National committee for quality assurance - level 1 medical home
G9149 National committee for quality assurance - level 2 medical home
G9150 National committee for quality assurance - level 3 medical home
G9151 Mapcp demonstration - state provided services
G9152 Mapcp demonstration - community health teams
G9153 Mapcp demonstration - physician incentive pool
G9156 Evaluation for wheelchair requiring face to face visit with physician
G9157 Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes
G9158 Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting
G9159 Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals
G9160 Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9161 Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting
G9162 Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals
G9163 Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9164 Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting
G9165 Attention functional limitation, current status at therapy episode outset and at reporting intervals
G9166 Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9167 Attention functional limitation, discharge status at discharge from therapy or to end reporting
G9168 Memory functional limitation, current status at therapy episode outset and at reporting intervals
G9169 Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9170 Memory functional limitation, discharge status at discharge from therapy or to end reporting
G9171 Voice functional limitation, current status at therapy episode outset and at reporting intervals
G9172 Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9173 Voice functional limitation, discharge status at discharge from therapy or to end reporting
G9174 Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals
G9175 Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9176 Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting
G9186 Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G9187 Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code
G9188 Beta-blocker therapy not prescribed, reason not given
G9189 Beta-blocker therapy prescribed or currently being taken
G9190 Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)
G9191 Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)
G9192 Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)
G9193 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
Terminated December 31, 2014.
G9194 Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase
Terminated December 31, 2014.
G9195 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
Terminated December 31, 2014.
G9196 Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))
G9197 Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis
G9198 Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given
G9199 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))
Terminated December 31, 2014.
G9200 Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
Terminated December 31, 2014.
G9201 Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
Terminated December 31, 2014.
G9202 Patients with a positive hepatitis c antibody test
Terminated December 31, 2014.
G9203 Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
Terminated December 31, 2016.
G9204 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
Terminated December 31, 2016.
G9205 Patient starting antiviral treatmentfor hepatitis c during the measurement period
Terminated December 31, 2016.
G9206 Patient starting antiviral treatment for hepatitis c during the measurement period
Terminated December 31, 2016.
G9207 Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
Terminated December 31, 2016.
G9208 Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
Terminated December 31, 2016.
G9209 Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment
Terminated December 31, 2016.
G9210 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)
Terminated December 31, 2016.
G9211 Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given
Terminated December 31, 2016.
G9212 Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation
G9213 Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified
G9214 Cd4+ cell count or cd4+ cell percentage results documented
Terminated December 31, 2014.
G9215 Cd4+ cell count or percentage not documented as performed, reason not given
Terminated December 31, 2014.
G9216 Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given
Terminated December 31, 2014.
G9217 Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given
Terminated December 31, 2016.
G9218 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
Terminated December 31, 2014.
G9219 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)
Terminated December 31, 2016.
G9220 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)
Terminated December 31, 2014.
G9221 Pneumocystis jiroveci pneumonia prophlaxis prescribed
Terminated December 31, 2014.
G9222 Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
Terminated December 31, 2016.
G9223 Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%
G9224 Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)
Terminated December 31, 2014.
G9225 Foot exam was not performed, reason not given
G9226 Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)
G9227 Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter
G9228 Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)
G9229 Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)
G9230 Chlamydia, gonorrhea, and syphilis not screened, reason not given
G9231 Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period
G9232 Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)
G9233 All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
Terminated December 31, 2016.
G9234 I intend to report the total knee replacement measures group
Terminated December 31, 2016.
G9235 All quality actions for the applicable measures in the general surgery measures group have been performed for this patient
Terminated December 31, 2016.
G9236 All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient
Terminated December 31, 2016.
G9237 I intend to report the general surgery measures group
Terminated December 31, 2016.
G9238 I intend to report the optimizing patient exposure to ionizing radiation measures group
Terminated December 31, 2016.
G9239 Documentation of reasons for patient initiaiting maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing avf/avg, time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)
G9240 Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated
G9241 Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated
G9242 Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed
G9243 Documentation of viral load less than 200 copies/ml
G9244 Antiretroviral thereapy not prescribed
Terminated December 31, 2016.
G9245 Antiretroviral therapy prescribed
Terminated December 31, 2016.
G9246 Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits
G9247 Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits
G9248 Patient did not have a medical visit in the last 6 months
Terminated December 31, 2014.
G9249 Patient had a medical visit in the last 6 months
Terminated December 31, 2014.
G9250 Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment
G9251 Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment
G9252 Adenoma(s) or other neoplasm detected during screening colonoscopy
Terminated December 31, 2014.
G9253 Adenoma(s) or other neoplasm not detected during screening colonoscopy
Terminated December 31, 2014.
G9254 Documentation of patient discharged to home later than post-operative day 2 following cas
G9255 Documentation of patient discharged to home no later than post operative day 2 following cas
G9256 Documentation of patient death following cas
G9257 Documentation of patient stroke following cas
G9258 Documentation of patient stroke following cea
G9259 Documentation of patient survival and absence of stroke following cas
G9260 Documentation of patient death following cea
G9261 Documentation of patient survival and absence of stroke following cea
G9262 Documentation of patient death in the hospital following endovascular aaa repair
G9263 Documentation of patient discharged alive following endovascular aaa repair
G9264 Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined avf/avg, other patient reasons)
G9265 Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access
G9266 Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access
G9267 Documentation of patient with one or more complications or mortality within 30 days
G9268 Documentation of patient with one or more complications within 90 days
G9269 Documentation of patient without one or more complications and without mortality within 30 days
G9270 Documentation of patient without one or more complications within 90 days
G9271 Ldl value < 100
Terminated December 31, 2014.
G9272 Ldl value >= 100
Terminated December 31, 2014.
G9273 Blood pressure has a systolic value of < 140 and a diastolic value of < 90
G9274 Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
G9275 Documentation that patient is a current non-tobacco user
G9276 Documentation that patient is a current tobacco user
G9277 Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)
G9278 Documentation that the patient is not on daily aspirin or anti-platelet regimen
G9279 Pneumococcal screening performed and documentation of vaccination received prior to discharge
G9280 Pneumococcal vaccination not administered prior to discharge, reason not specified
G9281 Screening performed and documentation that vaccination not indicated/patient refusal
G9282 Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)
G9283 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
G9284 Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
G9285 Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer
G9286 Antibiotic regimen prescribed within 10 days after onset of symptoms
G9287 Antibiotic regimen not prescribed within 10 days after onset of symptoms
G9288 Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)
G9289 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
G9290 Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
G9291 Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos
G9292 Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)
G9293 Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9294 Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9295 Specimen site other than anatomic cutaneous location
G9296 Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure
G9297 Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given
G9298 Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)
G9299 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)
G9300 Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)
G9301 Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
G9302 Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given
G9303 Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given
G9304 Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant
G9305 Intervention for presence of leak of endoluminal contents through an anastomosis not required
G9306 Intervention for presence of leak of endoluminal contents through an anastomosis required
G9307 No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
G9308 Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
G9309 No unplanned hospital readmission within 30 days of principal procedure
G9310 Unplanned hospital readmission within 30 days of principal procedure
G9311 No surgical site infection
G9312 Surgical site infection
G9313 Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason
G9314 Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given
G9315 Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis
G9316 Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family
G9317 Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed
G9318 Imaging study named according to standardized nomenclature
G9319 Imaging study not named according to standardized nomenclature, reason not given
G9320 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)
Terminated December 31, 2015.
G9321 Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study
G9322 Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given
G9323 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)
Terminated December 31, 2015.
G9324 All necessary data elements not included, reason not given
Terminated December 31, 2016.
G9325 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)
Terminated December 31, 2015.
G9326 Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given
G9327 Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements
G9328 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)
Terminated December 31, 2015.
G9329 Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given
G9340 Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study
G9341 Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed
G9342 Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given
G9343 Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)
Terminated December 31, 2015.
G9344 Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)
G9345 Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors
G9346 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)
Terminated December 31, 2015.
G9347 Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given
G9348 Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons
G9349 Documentation of a ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
G9350 Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis
G9351 More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis
G9352 More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given
G9353 More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)
G9354 One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis
G9355 Elective delivery or early induction not performed
G9356 Elective delivery or early induction performed
G9357 Post-partum screenings, evaluations and education performed
G9358 Post-partum screenings, evaluations and education not performed
G9359 Documentation of negative or managed positive tb screen with further evidence that tb is not active within one year of patient visit
G9360 No documentation of negative or managed positive tb screen
G9361 Medical indication for induction [documentation of reason(s) for elective delivery (c-section) or early induction (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes-premature or prolonged, maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]
G9362 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
Terminated December 31, 2015.
G9363 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
Terminated December 31, 2015.
G9364 Sinusitis caused by, or presumed to be caused by, bacterial infection
G9365 One high-risk medication ordered
G9366 One high-risk medication not ordered
G9367 At least two different high-risk medications ordered
G9368 At least two different high-risk medications not ordered
G9369 Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater
Terminated December 31, 2015.
G9370 Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater
Terminated December 31, 2015.
G9376 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery
Terminated December 31, 2015.
G9377 Patient did not have the retina attached after 6 months following only one surgery
Terminated December 31, 2015.
G9378 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)
Terminated December 31, 2015.
G9379 Patient did not achieve flat retinas six months post surgery
Terminated December 31, 2015.
G9380 Patient offered assistance with end of life issues during the measurement period
G9381 Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period
Terminated December 31, 2017.
G9382 Patient not offered assistance with end of life issues during the measurement period
G9383 Patient received screening for hcv infection within the 12 month reporting period
G9384 Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)
G9385 Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)
G9386 Screening for hcv infection not received within the 12 month reporting period, reason not given
G9389 Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9390 No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9391 Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
Terminated December 31, 2015.
G9392 Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
Terminated December 31, 2015.
G9393 Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five
G9394 Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period
G9395 Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five
G9396 Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)
G9399 Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment
G9400 Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons
G9401 No 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
G9402 Patient received follow-up on the date of discharge or within 30 days after discharge
G9403 Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)
G9404 Patient did not receive follow-up on the date of discharge or within 30 days after discharge
G9405 Patient received follow-up within 7 days from discharge
G9406 Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)
G9407 Patient did not receive follow-up on or within 7 days after discharge
G9408 Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
G9409 Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days
G9410 Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9411 Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9412 Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9413 Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
G9414 Patient had one dose of meningococcal vaccine on or between the patient's 11th and 13th birthdays
G9415 Patient did not have one dose of meningococcal vaccine on or between the patient's 11th and 13th birthdays
G9416 Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
G9417 Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays
G9418 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
G9419 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)
G9420 Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer
G9421 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
G9422 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)
G9423 Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]
G9424 Specimen site other than anatomic location of lung, or classified as nsclc-nos
G9425 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)
G9426 Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients
G9427 Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients
G9428 Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9429 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)
G9430 Specimen site other than anatomic cutaneous location
G9431 Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9432 Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented
G9433 Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period
Terminated December 31, 2015.
G9434 Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given
G9435 Aspirin prescribed at discharge
Terminated December 31, 2016.
G9436 Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
Terminated December 31, 2016.
G9437 Aspirin not prescribed at discharge
Terminated December 31, 2016.
G9438 P2y inhibitor prescribed at discharge
Terminated December 31, 2016.
G9439 P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
Terminated December 31, 2016.
G9440 P2y inhibitor not prescribed at discharge
Terminated December 31, 2016.
G9441 Statin prescribed at discharge
Terminated December 31, 2016.
G9442 Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)
Terminated December 31, 2016.
G9443 Statin not prescribed at discharge
Terminated December 31, 2016.
G9448 Patients who were born in the years 1945?1965
G9449 History of receiving blood transfusions prior to 1992
G9450 History of injection drug use
G9451 Patient received one-time screening for hcv infection
G9452 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)
G9453 Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)
G9454 One-time screening for hcv infection not received within 12 month reporting period and no documentation of prior screening for hcv infection, reason not given
G9455 Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc
G9456 Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)
G9457 Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the reporting period
G9458 Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user
G9459 Currently a tobacco non-user
G9460 Tobacco assessment or tobacco cessation intervention not performed, reason not given
G9463 I intend to report the sinusitis measures group
Terminated December 31, 2016.
G9464 All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient
Terminated December 31, 2016.
G9465 I intend to report the acute otitis externa (aoe) measures group
Terminated December 31, 2016.
G9466 All quality actions for the applicable measures in the aoe measures group have been performed for this patient
Terminated December 31, 2016.
G9467 Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months
Terminated December 31, 2016.
G9468 Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
G9469 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
G9470 Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
G9471 Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented
G9472 Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
G9473 Services performed by chaplain in the hospice setting, each 15 minutes
G9474 Services performed by dietary counselor in the hospice setting, each 15 minutes
G9475 Services performed by other counselor in the hospice setting, each 15 minutes
G9476 Services performed by volunteer in the hospice setting, each 15 minutes
G9477 Services performed by care coordinator in the hospice setting, each 15 minutes
G9478 Services performed by other qualified therapist in the hospice setting, each 15 minutes
G9479 Services performed by qualified pharmacist in the hospice setting, each 15 minutes
G9480 Admission to medicare care choice model program (mccm)
G9481 Remote in-home visit for the evaluation and management of a new patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9482 Remote in-home visit for the evaluation and management of a new patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9483 Remote in-home visit for the evaluation and management of a new patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9484 Remote in-home visit for the evaluation and management of a new patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9485 Remote in-home visit for the evaluation and management of a new patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9486 Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9487 Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9488 Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9489 Remote in-home visit for the evaluation and management of an established patient for use only in the medicare-approved comprehensive care for joint replacement model, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9490 Comprehensive care for joint replacement model, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in the medicare-approved cjr model); may not be billed for a 30 day period covered by a transitional care management code
G9496 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
Terminated December 31, 2017.
G9497 Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery
G9498 Antibiotic regimen prescribed
G9499 Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period
Terminated December 31, 2016.
G9500 Radiation exposure indices, or exposure time and number of fluorographic images in final report for procedures using fluoroscopy, documented
G9501 Radiation exposure indices, or exposure time and number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not given
G9502 Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
G9503 Patient taking tamsulosin hydrochloride
G9504 Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
G9505 Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
G9506 Biologic immune response modifier prescribed
G9507 Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
G9508 Documentation that the patient is not on a statin medication
G9509 Remission at twelve months as demonstrated by a twelve month (+/-30 days) phq-9 score of less than 5
G9510 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
G9511 Index date phq-9 score greater than 9 documented during the twelve month denominator identification period
G9512 Individual had a pdc of 0.8 or greater
G9513 Individual did not have a pdc of 0.8 or greater
G9514 Patient required a return to the operating room within 90 days of surgery
G9515 Patient did not require a return to the operating room within 90 days of surgery
G9516 Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
G9517 Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
G9518 Documentation of active injection drug use
G9519 Patient achieves final refraction (spherical equivalent) +/- 0.5 diopters of their planned refraction within 90 days of surgery
G9520 Patient does not achieve final refraction (spherical equivalent) +/- 0.5 diopters of their planned refraction within 90 days of surgery
G9521 Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
G9522 Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
G9523 Patient discontinued from hemodialysis or peritoneal dialysis
G9524 Patient was referred to hospice care
G9525 Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
G9526 Patient was not referred to hospice care, reason not given
G9529 Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
G9530 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
G9531 Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, pregnancy, or is currently taking an antiplatelet medication including: asa/dipyridamole, clopidogrel, prasugrel, ticlopidine, ticagrelor or cilstazol)
G9532 Patient's head injury occurred greater than 24 hours before presentation to the emergency department, or has a gcs score less than 15 or does not have a gcs score documented, 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
G9533 Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
G9534 Advanced brain imaging (cta, ct, mra or mri) was not ordered
G9535 Patients with a normal neurological examination
G9536 Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
G9537 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)
G9538 Advanced brain imaging (cta, ct, mra or mri) was ordered
G9539 Intent for potential removal at time of placement
G9540 Patient alive 3 months post procedure
G9541 Filter removed within 3 months of placement
G9542 Documented re-assessment for the appropriateness of filter removal within 3 months of placement
G9543 Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
G9544 Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
G9547 Incidental finding: liver lesion <= 0.5 cm, cystic kidney lesion < 1.0 cm or adrenal lesion <= 1.0 cm
G9548 Final reports for abdominal imaging studies with follow-up imaging recommended
G9549 Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has a known malignancy that can metastasize, other medical reason(s) such as fever in an immunocompromised patient)
G9550 Final reports for abdominal imaging studies with follow-up imaging not recommended
G9551 Final reports for abdominal imaging studies without an incidentally found lesion noted: liver lesion <= 0.5 cm, cystic kidney lesion < 1.0 cm or adrenal lesion <= 1.0 cm noted or no lesion found
G9552 Incidental thyroid nodule < 1.0 cm noted in report
G9553 Prior thyroid disease diagnosis
G9554 Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging recommended
G9555 Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))
G9556 Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging not recommended
G9557 Final reports for ct, cta, mri or mra studies of the chest or neck or ultrasound of the neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found
G9558 Patient treated with a beta-lactam antibiotic as definitive therapy
G9559 Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)
G9560 Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given
G9561 Patients prescribed opiates for longer than six weeks
G9562 Patients who had a follow-up evaluation conducted at least every three months during opioid therapy
G9563 Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy
G9572 Index date phq-score greater than 9 documented during the twelve month denominator identification period
Terminated December 31, 2016.
G9573 Remission at six months as demonstrated by a six month (+/-30 days) phq-9 score of less than five
G9574 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
G9577 Patients prescribed opiates for longer than six weeks
G9578 Documentation of signed opioid treatment agreement at least once during opioid therapy
G9579 No documentation of signed an opioid treatment agreement at least once during opioid therapy
G9580 Door to puncture time of less than 2 hours
G9581 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)
Terminated December 31, 2016.
G9582 Door to puncture time of greater than 2 hours, no reason given
G9583 Patients prescribed opiates for longer than six weeks
G9584 Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy
G9585 Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy
G9593 Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules
G9594 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
G9595 Patient has documentation of ventricular shunt, brain tumor, coagulopathy, including thrombocytopenia
G9596 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 does not have a gcs score documented, 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
G9597 Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules
G9598 Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct
G9599 Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct
G9600 Symptomatic aaas that required urgent/emergent (non-elective) repair
G9601 Patient discharge to home no later than post-operative day #7
G9602 Patient not discharged to home by post-operative day #7
G9603 Patient survey score improved from baseline following treatment
G9604 Patient survey results not available
G9605 Patient survey score did not improve from baseline following treatment
G9606 Intraoperative cystoscopy performed to evaluate for lower tract injury
G9607 Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death
G9608 Intraoperative cystoscopy not performed to evaluate for lower tract injury
G9609 Documentation of an order for anti-platelet agents
G9610 Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents
G9611 Order for anti-platelet agents was not documented in the patient's record, reason not given
G9612 Photodocumentation of one or more cecal landmarks to establish a complete examination
G9613 Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)
G9614 No photodocumentation of cecal landmarks to establish a complete examination
G9615 Preoperative assessment documented
G9616 Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)
G9617 Preoperative assessment not documented, reason not given
G9618 Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind
G9619 Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)
Terminated December 31, 2016.
G9620 Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given
G9621 Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling
G9622 Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method
G9623 Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)
G9624 Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given
G9625 Patient sustained bladder injury at the time of surgery or discovered subsequently up to 1 month post-surgery
G9626 Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury)
G9627 Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 1 month post-surgery
G9628 Patient sustained bowel injury at the time of surgery or discovered subsequently up to 1 month post-surgery
G9629 Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury)
G9630 Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 1 month post-surgery
G9631 Patient sustained ureter injury at the time of surgery or discovered subsequently up to 1 month post-surgery
G9632 Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury)
G9633 Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 1 month post-surgery
G9634 Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved
G9635 Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)
G9636 Health-related quality of life not assessed with tool during at least two visits or quality of life score declined
G9637 At least two orders for the same high-risk medication
G9638 At least two orders for the same high-risk medications not ordered
G9639 Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure
G9640 Documentation of planned hybrid or staged procedure
G9641 Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure
G9642 Current smokers (e.g., cigarette, cigar, pipe, e-cigarette or marijuana)
G9643 Elective surgery
G9644 Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure
G9645 Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure
G9646 Patients with 90 day mrs score of 0 to 2
G9647 Patients in whom mrs score could not be obtained at 90 day follow-up
G9648 Patients with 90 day mrs score greater than 2
G9649 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))
G9650 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
Terminated December 31, 2016.
G9651 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
G9652 Patient has been treated with a systemic or biologic medication for psoriasis for at least six months
Terminated December 31, 2016.
G9653 Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months
Terminated December 31, 2016.
G9654 Monitored anesthesia care (mac)
G9655 A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used
G9656 Patient transferred directly from anesthetizing location to pacu or other non-icu location
G9657 Transfer of care during an anesthetic or to the intensive care unit
Terminated December 31, 2016.
G9658 A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used
G9659 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
G9660 Documentation of medical reason(s) for a colonoscopy performed on a patient greater than 85 years of age (e.g., 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)
G9661 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 diagnosed advance lesions
G9662 Previously diagnosed or have an active diagnosis of clinical ascvd
G9663 Any fasting or direct ldl-c laboratory test result = 190 mg/dl
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy
G9665 Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy
G9666 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
G9667 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)
Terminated December 31, 2016.
G9669 I intend to report the multiple chronic conditions measures group
Terminated December 31, 2016.
G9670 All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient
Terminated December 31, 2016.
G9671 I intend to report the diabetic retinopathy measures group
Terminated December 31, 2016.
G9672 All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient
Terminated December 31, 2016.
G9673 I intend to report the cardiovascular prevention measures group
Terminated December 31, 2016.
G9674 Patients with clinical ascvd diagnosis
G9675 Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
G9676 Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70?189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period
G9677 All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient
Terminated December 31, 2016.
G9678 Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement
G9679 This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary
G9680 This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary
G9681 This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary
G9682 This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary
G9683 This code is for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder or dehydration (similar pattern); may only be billed once per day per beneficiary
G9684 This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary
G9685 This code is for the evaluation and management of a beneficiary's acute change in condition in a nursing facility
G9686 Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team
G9687 Hospice services provided to patient any time during the measurement period
G9688 Patients using hospice services any time during the measurement period
G9689 Patient admitted for performance of elective carotid intervention
G9690 Patient receiving hospice services any time during the measurement period
G9691 Patient had hospice services any time during the measurement period
G9692 Hospice services received by patient any time during the measurement period
G9693 Patient use of hospice services any time during the measurement period
G9694 Hospice services utilized by patient any time during the measurement period
G9695 Long-acting inhaled bronchodilator prescribed
G9696 Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator
G9697 Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator
G9698 Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator
G9699 Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified
G9700 Patients who use hospice services any time during the measurement period
G9701 Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established
G9702 Patients who use hospice services any time during the measurement period
G9703 Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis
G9704 Ajcc breast cancer stage i: t1 mic or t1a documented
G9705 Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented
G9706 Low (or very low) risk of recurrence, prostate cancer
G9707 Patient received hospice services any time during the measurement period
G9708 Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
G9709 Hospice services used by patient any time during the measurement period
G9710 Patient was provided hospice services any time during the measurement period
G9711 Patients with a diagnosis or past history of total colectomy or colorectal cancer
G9712 Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis
G9713 Patients who use hospice services any time during the measurement period
G9714 Patient is using hospice services any time during the measurement period
G9715 Patients who use hospice services any time during the measurement period
G9716 Bmi is documented as being outside of normal limits, follow-up plan is not completed for documented reason
G9717 Documentation stating the patient has an active diagnosis of depression or has a diagnosed bipolar disorder, therefore screening or follow-up not required
G9718 Hospice services for patient provided any time during the measurement period
G9719 Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9720 Hospice services for patient occurred any time during the measurement period
G9721 Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9722 Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher
G9723 Hospice services for patient received any time during the measurement period
G9724 Patients who had documentation of use of anticoagulant medications overlapping the measurement year
G9725 Patients who use hospice services any time during the measurement period
G9726 Patient refused to participate
G9727 Patient unable to complete the foto knee intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9728 Patient refused to participate
G9729 Patient unable to complete the foto hip intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9730 Patient refused to participate
G9731 Patient unable to complete the foto foot or ankle intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9732 Patient refused to participate
G9733 Patient unable to complete the foto lumbar intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9734 Patient refused to participate
G9735 Patient unable to complete the foto shoulder intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9736 Patient refused to participate
G9737 Patient unable to complete the foto elbow, wrist or hand intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9738 Patient refused to participate
G9739 Patient unable to complete the foto general orthopedic intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9740 Hospice services given to patient any time during the measurement period
G9741 Patients who use hospice services any time during the measurement period
G9742 Psychiatric symptoms assessed
G9743 Psychiatric symptoms not assessed, reason not otherwise specified
G9744 Patient not eligible due to active diagnosis of hypertension
G9745 Documented reason for not screening or recommending a follow-up for high blood pressure
G9746 Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9747 Patient is undergoing palliative dialysis with a catheter
G9748 Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9749 Patient is undergoing palliative dialysis with a catheter
G9750 Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9751 Patient died at any time during the 24-month measurement period
G9752 Emergency surgery
G9753 Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)
G9754 A finding of an incidental pulmonary nodule
G9755 Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has a known malignancy that can metastasize, other medical reason(s)
G9756 Surgical procedures that included the use of silicone oil
G9757 Surgical procedures that included the use of silicone oil
G9758 Patient in hospice at any time during the measurement period
G9759 History of preoperative posterior capsule rupture
G9760 Patients who use hospice services any time during the measurement period
G9761 Patients who use hospice services any time during the measurement period
G9762 Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9763 Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9764 Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris
G9765 Documentation that the patient declined therapy change or alternative therapies were unavailable, has documented contraindications, or has not been treated with an oral systemic or biologic for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
G9766 Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment
G9767 Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment
G9768 Patients who utilize hospice services any time during the measurement period
G9769 Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months
G9770 Peripheral nerve block (pnb)
G9771 At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time
G9772 Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)
G9773 At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time
G9774 Patients who have had a hysterectomy
G9775 Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9776 Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9777 Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9778 Patients who have a diagnosis of pregnancy
G9779 Patients who are breastfeeding
G9780 Patients who have a diagnosis of rhabdomyolysis
G9781 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 are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, and patients with end stage renal disease (esrd))
G9782 History of or active diagnosis of familial or pure hypercholesterolemia
G9783 Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy
G9784 Pathologists/dermatopathologists providing a second opinion on a biopsy
G9785 Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9786 Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9787 Patient alive as of the last day of the measurement year
G9788 Most recent bp is less than or equal to 140/90 mm hg
G9789 Blood pressure recorded during inpatient stays, emergency room visits, urgent care visits, and patient self-reported bp's (home and health fair bp results)
G9790 Most recent bp is greater than 140/90 mm hg, or blood pressure not documented
G9791 Most recent tobacco status is tobacco free
G9792 Most recent tobacco status is not tobacco free
G9793 Patient is currently on a daily aspirin or other antiplatelet
G9794 Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)
G9795 Patient is not currently on a daily aspirin or other antiplatelet
G9796 Patient is currently on a statin therapy
G9797 Patient is not on a statin therapy
G9798 Discharge(s) for ami between july 1 of the year prior measurement year to june 30 of the measurement period
G9799 Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period
G9800 Patients who are identified as having an intolerance or allergy to beta-blocker therapy
G9801 Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis`
G9802 Patients who use hospice services any time during the measurement period
G9803 Patient prescribed a 180-day course of treatment with beta-blockers post discharge for ami
G9804 Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for ami
G9805 Patients who use hospice services any time during the measurement period
G9806 Patients who received cervical cytology or an hpv test
G9807 Patients who did not receive cervical cytology or an hpv test
G9808 Any patients who had no asthma controller medications dispensed during the measurement year
G9809 Patients who use hospice services any time during the measurement period
G9810 Patient achieved a pdc of at least 75% for their asthma controller medication
G9811 Patient did not achieve a pdc of at least 75% for their asthma controller medication
G9812 Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure
G9813 Patient did not die within 30 days of the procedure or during the index hospitalization
G9814 Death occurring during the index acute care hospitalization
G9815 Death did not occur during the index acute care hospitalization
G9816 Death occurring after discharge from the hospital but within 30 days post procedure
G9817 Death did not occur after discharge from the hospital within 30 days post procedure
G9818 Documentation of sexual activity
G9819 Patients who use hospice services any time during the measurement period
G9820 Documentation of a chlamydia screening test with proper follow-up
G9821 No documentation of a chlamydia screening test with proper follow-up
G9822 Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)
G9823 Endometrial sampling or hysteroscopy with biopsy and results documented
G9824 Endometrial sampling or hysteroscopy with biopsy and results not documented
G9825 Her-2/neu negative or undocumented/unknown
G9826 Patient transferred to practice after initiation of chemotherapy
G9827 Her2-targeted therapies not administered during the initial course of treatment
G9828 Her2-targeted therapies administered during the initial course of treatment
G9829 Breast adjuvant chemotherapy administered
G9830 Her-2/neu positive
G9831 Ajcc stage at breast cancer diagnosis = ii or iii
G9832 Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis does not equal = t1, t1a, t1b
G9833 Patient transfer to practice after initiation of chemotherapy
G9834 Patient has metastatic disease at diagnosis
G9835 Trastuzumab administered within 12 months of diagnosis
G9836 Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
G9837 Trastuzumab not administered within 12 months of diagnosis
G9838 Patient has metastatic disease at diagnosis
G9839 Anti-egfr monoclonal antibody therapy
G9840 Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab
G9841 Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab
G9842 Patient has metastatic disease at diagnosis
G9843 Ras (kras or nras) gene mutation
G9844 Patient did not receive anti-egfr monoclonal antibody therapy
G9845 Patient received anti-egfr monoclonal antibody therapy
G9846 Patients who died from cancer
G9847 Patient received chemotherapy in the last 14 days of life
G9848 Patient did not receive chemotherapy in the last 14 days of life
G9849 Patients who died from cancer
G9850 Patient had more than one emergency department visit in the last 30 days of life
G9851 Patient had one or less emergency department visits in the last 30 days of life
G9852 Patients who died from cancer
G9853 Patient admitted to the icu in the last 30 days of life
G9854 Patient was not admitted to the icu in the last 30 days of life
G9855 Patients who died from cancer
G9856 Patient was not admitted to hospice
G9857 Patient admitted to hospice
G9858 Patient enrolled in hospice
G9859 Patients who died from cancer
G9860 Patient spent less than three days in hospice care
G9861 Patient spent greater than or equal to three days in hospice care
G9862 Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)
G9890 Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity
G9891 Documentation of medical reason(s) for not performing a dilated macular examination
G9892 Documentation of patient reason(s) for not performing a dilated macular examination
G9893 Dilated macular exam was not performed, reason not otherwise specified
G9894 Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate
G9895 Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)
G9896 Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate
G9897 Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given
G9898 Patient age 65 or older in institutinal special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 any time during the measurement period
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed
G9900 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
G9901 Patient age 65 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 any time during the measurement period
G9902 Patient screened for tobacco use and identified as a tobacco user
G9903 Patient screened for tobacco use and identified as a tobacco non-user
G9904 Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
G9905 Patient not screened for tobacco use, reason not given
G9906 Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)
G9907 Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)
G9908 Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy), reason not given
G9909 Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (eg, limited life expectancy, other medical reason)
G9910 Patients age 65 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 anytime during the measurement period
G9911 Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
G9912 Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy
G9913 Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not given
G9914 Patient receiving an anti-tnf agent
G9915 No record of hbv results documented
G9916 Functional status performed once in the last 12 months
G9917 Documentation of medical reason(s) for not performing functional status (e.g., patient is severely impaired and caregiver knowledge is limited, other medical reason)
G9918 Functional status not performed, reason not otherwise specified
G9919 Screening performed and positive and provision of recommendations
G9920 Screening performed and negative
G9921 No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified
G9922 Safety concerns screen provided and if positive then documented mitigation recommendations
G9923 Safety concerns screen provided and negative
G9924 Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)
G9925 Safety concerns screening not provided, reason not otherwise specified
G9926 Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources
G9927 Documentation of system reason(s) for not prescribing warfarin or another fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment
G9928 Warfarin or another fda-approved anticoagulant not prescribed, reason not given
G9929 Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9930 Patients who are receiving comfort care only
G9931 Documentation of cha2ds2-vasc risk score of 0 or 1
G9932 Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)
G9933 Adenoma(s) or colorectal cancer detected during screening colonoscopy
G9934 Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
G9935 Adenoma(s) or colorectal cancer not detected during screening colonoscopy
G9936 Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
G9937 Diagnostic colonoscopy
G9938 Patients age 65 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 any time during the measurement period
G9939 Pathologists/dermatopathologists is the same clinician who performed the biopsy
G9940 Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)
G9941 Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
G9942 Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
G9943 Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively
G9944 Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9945 Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis
G9946 Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9947 Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
G9948 Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
G9949 Leg pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
G9954 Patient exhibits 2 or more risk factors for post-operative vomiting
G9955 Cases in which an inhalational anesthetic is used only for induction
G9956 Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9957 Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9958 Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9959 Systemic antimicrobials not prescribed
G9960 Documentation of medical reason(s) for prescribing systemic antimicrobials
G9961 Systemic antimicrobials prescribed
G9962 Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy
G9963 Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy
G9964 Patient received at least one well-child visit with a pcp during the performance period
G9965 Patient did not receive at least one well-child visit with a pcp during the performance period
G9966 Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9967 Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9968 Patient was referred to another provider or specialist during the performance period
G9969 Provider who referred the patient to another provider received a report from the provider to whom the patient was referred
G9970 Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred
G9974 Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity
G9975 Documentation of medical reason(s) for not performing a dilated macular examination
G9976 Documentation of patient reason(s) for not performing a dilated macular examination
G9977 Dilated macular exam was not performed, reason not otherwise specified