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HCPCSG0000–G9999

HCPCS G — Procedures and Professional Services (Temporary)

CMS's own codes for services with no CPT equivalent, or where Medicare wants different rules. Temporary in name only — many have been in use for decades.

2,010 codes in the current CMS release, 1,275 of them still active.

735 terminated G codes (no longer billable, kept for old claims)
  • G0028Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
  • G0056Optimizing chronic disease management mips value pathways
  • G0071Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only
  • G0106Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
  • G0120Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
  • G0122Colorectal cancer screening; barium enema
  • G0154Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes
  • G0163Skilled 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)
  • G0164Skilled 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
  • G0173Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session
  • G0202Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
  • G0204Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
  • G0206Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
  • G0251Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment
  • G0297Low dose ct scan (ldct) for lung cancer screening
  • G0308Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training
  • G0309Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
  • G0364Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
  • G0365Vessel 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)
  • G0389Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
  • G0417Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens
  • G0418Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens
  • G0419Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens
  • G0424Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
  • G0431Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
  • G0434Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
  • G0436Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
  • G0437Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
  • G0456Negative 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
  • G0457Negative 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
  • G0461Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
  • G0462Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)
  • G0464Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
  • G0477Drug 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
  • G0478Drug 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
  • G0479Drug 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
  • G0502Initial 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
  • G0503Subsequent 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
  • G0504Initial 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)
  • G0505Cognition 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
  • G0507Care 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
  • G0511Rural 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
  • G0512Rural 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
  • G0515Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
  • G0564Creation of subcutaneous pocket with insertion of 365 day implantable interstitial glucose sensor, including system activation and patient training
  • G0565Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 365 day implantable sensor, including system activation
  • G0908Most recent hemoglobin (hgb) level > 12.0 g/dl
  • G0909Hemoglobin level measurement not documented, reason not given
  • G0910Most recent hemoglobin level <= 12.0 g/dl
  • G0919Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit
  • G0920Type, anatomic location, and activity all documented
  • G0921Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)
  • G0922No documentation of disease type, anatomic location, and activity, reason not given
  • G1000Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program
  • G1001Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program
  • G1002Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program
  • G1003Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program
  • G1004Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program
  • G1005Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program
  • G1006Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program
  • G1007Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program
  • G1008Clinical decision support mechanism cranberry peak, as defined by the medicare appropriate use criteria program
  • G1009Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program
  • G1010Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program
  • G1011Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program
  • G1012Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria program
  • G1013Clinical decision support mechanism evidencecare imagingcare, as defined by the medicare appropriate use criteria program
  • G1014Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria program
  • G1015Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria program
  • G1016Clinical decision support mechanism speed of care, as defined by the medicare appropriate use criteria program
  • G1017Clinical decision support mechanism healthhelp, as defined by the medicare appropriate use criteria program
  • G1018Clinical decision support mechanism infinx, as defined by the medicare appropriate use criteria program
  • G1019Clinical decision support mechanism logicnets, as defined by the medicare appropriate use criteria program
  • G1020Clinical decision support mechanism curbside clinical augmented workflow, as defined by the medicare appropriate use criteria program
  • G1021Clinical decision support mechanism ehealthline clinical decision support mechanism, as defined by the medicare appropriate use criteria program
  • G1022Clinical decision support mechanism intermountain clinical decision support mechanism, as defined by the medicare appropriate use criteria program
  • G1023Clinical decision support mechanism persivia clinical decision support, as defined by the medicare appropriate use criteria program
  • G1024Clinical decision support mechanism radrite, as defined by the medicare appropriate use criteria program
  • G2012Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
  • G2023Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source
  • G2024Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source
  • G2058Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)).
  • G2061Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes
  • G2062Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes
  • G2063Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes
  • G2064Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities
  • G2065Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities
  • G2066Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results
  • G2070Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)
  • G2071Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)
  • G2072Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)
  • G2089Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%
  • G2095Documentation of system reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., other system reasons)
  • G2102Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed
  • G2103Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed
  • G2104Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed
  • G2108Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period
  • G2109Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
  • G2110Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
  • G2114Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
  • G2117Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
  • G2119Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed
  • G2120Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performed
  • G2123Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
  • G2124Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication
  • G2130Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period
  • G2131Patients 81 years and older with a diagnosis of frailty
  • G2132Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
  • G2133Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
  • G2134Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
  • G2135Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
  • G2153In hospice or using hospice services during the measurement period
  • G2154Patient received at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period
  • G2155Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)
  • G2156Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)
  • G2157Patients received both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during the measurement period
  • G2158Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period
  • G2159Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period
  • G2160Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period
  • G2161Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period
  • G2162Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period
  • G2163Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period
  • G2164Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period
  • G2165Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period
  • G2166Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason
  • G2170Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed
  • G2171Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed
  • G2198Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons)
  • G2201Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)
  • G2203Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)
  • G3001Administration and supply of tositumomab, 450 mg
  • G6001Ultrasonic guidance for placement of radiation therapy fields
  • G6002Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy
  • G6003Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev
  • G6004Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev
  • G6005Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev
  • G6006Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater
  • G6007Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev
  • G6008Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev
  • G6009Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev
  • G6010Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater
  • G6011Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev
  • G6012Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev
  • G6013Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev
  • G6014Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater
  • G6015Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
  • G6016Compensator-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
  • G6017Intra-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
  • G6018Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)
  • G6019Colonoscopy 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
  • G6020Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
  • G6021Unlisted procedure, intestine
  • G6022Sigmoidoscopy, 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
  • G6023Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)
  • G6024Colonoscopy, 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
  • G6025Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)
  • G6027Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed
  • G6028Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)
  • G6030Amitriptyline
  • G6031Benzodiazepines
  • G6032Desipramine
  • G6034Doxepin
  • G6035Gold
  • G6036Assay of imipramine
  • G6037Nortriptyline
  • G6038Salicylate
  • G6039Acetaminophen
  • G6040Alcohol (ethanol); any specimen except breath
  • G6041Alkaloids, urine, quantitative
  • G6042Amphetamine or methamphetamine
  • G6043Barbiturates, not elsewhere specified
  • G6044Cocaine or metabolite
  • G6045Dihydrocodeinone
  • G6046Dihydromorphinone
  • G6047Dihydrotestosterone
  • G6048Dimethadione
  • G6049Epiandrosterone
  • G6050Ethchlorvynol
  • G6051Flurazepam
  • G6052Meprobamate
  • G6053Methadone
  • G6054Methsuximide
  • G6055Nicotine
  • G6056Opiate(s), drug and metabolites, each procedure
  • G6057Phenothiazine
  • G6058Drug confirmation, each procedure
  • G8126Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
  • G8127Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
  • G8128Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure
  • G8398Dilated macular or fundus exam not performed
  • G8401Clinician documented that patient was not an eligible candidate for screening
  • G8406Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure
  • G8422Bmi not documented, documentation the patient is not eligible for bmi calculation
  • G8442Pain 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
  • G8458Clinician 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)
  • G8460Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c
  • G8461Patient receiving antiviral treatment for hepatitis c during the measurement period
  • G8464Clinician 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
  • G8482Influenza immunization administered or previously received
  • G8483Influenza 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)
  • G8484Influenza immunization was not administered, reason not given
  • G8485I intend to report the diabetes mellitus (dm) measures group
  • G8486I intend to report the preventive care measures group
  • G8487I intend to report the chronic kidney disease (ckd) measures group
  • G8489I intend to report the coronary artery disease (cad) measures group
  • G8490I intend to report the rheumatoid arthritis (ra) measures group
  • G8491I intend to report the hiv/aids measures group
  • G8492I intend to report the perioperative care measures group
  • G8493I intend to report the back pain measures group
  • G8494All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient
  • G8495All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient
  • G8496All quality actions for the applicable measures in the preventive care measures group have been performed for this patient
  • G8497All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient
  • G8498All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient
  • G8499All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient
  • G8500All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient
  • G8501All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient
  • G8502All quality actions for the applicable measures in the back pain measures group have been performed for this patient
  • G8506Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
  • G8509Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given
  • G8530Autogenous av fistula received
  • G8531Clinician documented that patient was not an eligible candidate for autogenous av fistula
  • G8532Clinician documented that patient received vascular access other than autogenous av fistula, reason not given
  • G8544I intend to report the coronary artery bypass graft (cabg) measures group
  • G8545I intend to report the hepatitis c measures group
  • G8547I intend to report the ischemic vascular disease (ivd) measures group
  • G8548I intend to report the heart failure (hf) measures group
  • G8549All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient
  • G8551All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient
  • G8552All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient
  • G8571Development of deep sternal wound infection/mediastinitis within 30 days postoperatively
  • G8572No deep sternal wound infection/mediastinitis
  • G8573Stroke following isolated cabg surgery
  • G8574No stroke following isolated cabg surgery
  • G8579Antiplatelet medication at discharge
  • G8580Antiplatelet medication contraindicated
  • G8581No antiplatelet medication at discharge
  • G8582Beta-blocker at discharge
  • G8583Beta-blocker contraindicated
  • G8584No beta-blocker at discharge
  • G8585Anti-lipid treatment at discharge
  • G8586Anti-lipid treatment contraindicated
  • G8587No anti-lipid treatment at discharge
  • G8593Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
  • G8594Lipid profile not performed, reason not given
  • G8595Most recent ldl-c < 100 mg/dl
  • G8597Most recent ldl-c >= 100 mg/dl
  • G8627Surgical 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)
  • G8628Surgical 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)
  • G8629Documentation 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)
  • G8630Documentation 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
  • G8631Clinician 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)
  • G8632Prophylactic 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
  • G8634Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
  • G8645I intend to report the asthma measures group
  • G8646All quality actions for the applicable measures in the asthma measures group have been performed for this patient
  • G8649Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8653Risk-adjusted functional status change residual scores for the hip impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8657Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8665Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8669Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8671Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
  • G8672Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)
  • G8673Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
  • G8674Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given
  • G8682Lvf testing documented as being performed prior to discharge or in the previous 12 months
  • G8683Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason
  • G8685Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given
  • G8696Antithrombotic therapy prescribed at discharge
  • G8697Antithrombotic 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))
  • G8698Antithrombotic therapy was not prescribed at discharge, reason not given
  • G8699Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge
  • G8700Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
  • G8701Rehabilitation services were not ordered, reason not otherwise specified
  • G8702Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
  • G8703Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
  • G870412-lead electrocardiogram (ecg) performed
  • G8705Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)
  • G8706Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)
  • G870712-lead electrocardiogram (ecg) not performed, reason not given
  • G8713Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])
  • G8714Hemodialysis treatment performed exactly three times per week for > 90 days
  • G8717Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given
  • G8718Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])
  • G8720Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])
  • G8725Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)
  • G8726Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
  • G8728Fasting lipid profile not performed, reason not given
  • G8730Pain assessment documented as positive using a standardized tool and a follow-up plan is documented
  • G8731Pain assessment using a standardized tool is documented as negative, no follow-up plan required
  • G8732No documentation of pain assessment, reason not given
  • G8736Most current ldl-c <100mg/dl
  • G8737Most current ldl-c >=100mg/dl
  • G8738Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function
  • G8739Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
  • G8740Left ventricular ejection fraction (lvef) not performed or assessed, reason not given
  • G8751Smoking status and exposure to second hand smoke in the home not assessed, reason not given
  • G8757All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient
  • G8758All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient
  • G8759All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient
  • G8761All quality actions for the applicable measures in the dementia measures group have been performed for this patient
  • G8762All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient
  • G8763All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient
  • G8764All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient
  • G8765All quality actions for the applicable measures in the cataract measures group have been performed for this patient
  • G8767Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
  • G8768Documentation 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)
  • G8769Lipid profile not performed, reason not given
  • G8770Urine protein test result documented and reviewed
  • G8771Documentation of diagnosis of chronic kidney disease
  • G8772Documentation 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)
  • G8773Urine protein test was not performed, reason not given
  • G8774Serum creatinine test result documented and reviewed
  • G8775Documentation 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)
  • G8776Serum creatinine test not performed, reason not given
  • G8777Diabetes screening test performed
  • G8778Documentation 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)
  • G8779Diabetes screening test not performed, reason not given
  • G8780Counseling for diet and physical activity performed
  • G8781Documentation 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)
  • G8782Counseling for diet and physical activity not performed, reason not given
  • G8784Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)
  • G8809Rh-immunoglobulin (rhogam) ordered
  • G8810Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)
  • G8811Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
  • G8818Patient discharge to home no later than post-operative day #7
  • G8825Patient not discharged to home by post-operative day #7
  • G8848Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)
  • G8852Positive airway pressure therapy was prescribed
  • G8853Positive airway pressure therapy not prescribed
  • G8859Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
  • G8860Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
  • G8861Within 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
  • G8862Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
  • G8868Patients receiving a first course of anti-tnf therapy
  • G8870Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
  • G8871Patient not receiving a first course of anti-tnf therapy
  • G8872Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
  • G8873Patients 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)
  • G8874Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
  • G8879Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
  • G8883Biopsy results reviewed, communicated, tracked and documented
  • G8884Clinician documented reason that patient's biopsy results were not reviewed
  • G8885Biopsy results not reviewed, communicated, tracked or documented
  • G8886Most recent blood pressure under control
  • G8887Documentation 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)
  • G8888Most recent blood pressure not under control, results documented and reviewed
  • G8889No documentation of blood pressure measurement, reason not given
  • G8890Most recent ldl-c under control, results documented and reviewed
  • G8891Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
  • G8892Documentation 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)
  • G8893Most recent ldl-c not under control, results documented and reviewed
  • G8894Ldl-c not performed, reason not given
  • G8895Oral aspirin or other antithrombotic therapy prescribed
  • G8896Documentation 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)
  • G8897Oral aspirin or other antithrombotic therapy was not prescribed, reason not given
  • G8898I intend to report the chronic obstructive pulmonary disease (copd) measures group
  • G8899I intend to report the inflammatory bowel disease (ibd) measures group
  • G8900I intend to report the sleep apnea measures group
  • G8902I intend to report the dementia measures group
  • G8903I intend to report the parkinson's disease measures group
  • G8904I intend to report the hypertension (htn) measures group
  • G8905I intend to report the cardiovascular prevention measures group
  • G8906I intend to report the cataract measures group
  • G8925Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms
  • G8926Spirometry test not performed or documented, reason not given
  • G8927Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer
  • G8928Adjuvant 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)
  • G8929Adjuvant chemotherapy not prescribed or previously received, reason not given
  • G8930Assessment of depression severity at the initial evaluation
  • G8931Assessment of depression severity not documented, reason not given
  • G8932Suicide risk assessed at the initial evaluation
  • G8933Suicide risk not assessed at the initial evaluation, reason not given
  • G8938Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
  • G8939Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter
  • G8940Screening for depression documented as positive, a follow-up plan not completed, documented reason
  • G8941Elder 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
  • G8943Ldl-c result not present or not within 12 months prior
  • G8947One or more neuropsychiatric symptoms
  • G8948No neuropsychiatric symptoms
  • G8949Documentation 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)
  • G8951Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible
  • G8953All quality actions for the applicable measures in the oncology measures group have been performed for this patient
  • G8957Patient not receiving maintenance hemodialysis in an outpatient dialysis facility
  • G8959Clinician treating major depressive disorder communicates to clinician treating comorbid condition
  • G8960Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given
  • G8963Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years
  • G8964Cardiac 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)
  • G8965Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment
  • G8966Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment
  • G8971Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
  • G8972One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
  • G8973Most recent hemoglobin (hgb) level < 10 g/dl
  • G8974Hemoglobin level measurement not documented, reason not given
  • G8975Documentation 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)
  • G8976Most recent hemoglobin (hgb) level >= 10 g/dl
  • G8977I intend to report the oncology measures group
  • G8978Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8979Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8980Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8981Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8982Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8983Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8984Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8985Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8986Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8987Self care functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8988Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8989Self care functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8990Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8991Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8992Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8993Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8994Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8995Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8996Swallowing functional limitation, current status at therapy episode outset and at reporting intervals
  • G8997Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8998Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting
  • G8999Motor speech functional limitation, current status at therapy episode outset and at reporting intervals
  • G9017Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
  • G9018Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)
  • G9019Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)
  • G9020Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
  • G9033Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)
  • G9034Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)
  • G9035Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)
  • G9036Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)
  • G9037Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified health care professional for the care of the patient (i.e. not for professional education or scheduling) and may include subsequent follow up on the specialist's recommendations; 30 minutes
  • G9038Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care planning; condition for which specialist is taking a co-management role; condition expected to last at least 3 months; comprehensive care plan established, implemented, revised or monitored in partnership with co-managing clinicians; ongoing communication and care coordination between co-managing clinicians furnishing care
  • G9158Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting
  • G9159Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals
  • G9160Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9161Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting
  • G9162Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals
  • G9163Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9164Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting
  • G9165Attention functional limitation, current status at therapy episode outset and at reporting intervals
  • G9166Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9167Attention functional limitation, discharge status at discharge from therapy or to end reporting
  • G9168Memory functional limitation, current status at therapy episode outset and at reporting intervals
  • G9169Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9170Memory functional limitation, discharge status at discharge from therapy or to end reporting
  • G9171Voice functional limitation, current status at therapy episode outset and at reporting intervals
  • G9172Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9173Voice functional limitation, discharge status at discharge from therapy or to end reporting
  • G9174Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals
  • G9175Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9176Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting
  • G9186Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G9192Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)
  • G9193Clinician 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
  • G9194Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase
  • G9195Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase
  • G9196Documentation 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))
  • G9197Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis
  • G9198Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given
  • G9199Venous 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))
  • G9200Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
  • G9201Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
  • G9202Patients with a positive hepatitis c antibody test
  • G9203Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
  • G9204Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
  • G9205Patient starting antiviral treatmentfor hepatitis c during the measurement period
  • G9206Patient starting antiviral treatment for hepatitis c during the measurement period
  • G9207Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
  • G9208Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
  • G9209Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment
  • G9210Hepatitis 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)
  • G9211Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given
  • G9214Cd4+ cell count or cd4+ cell percentage results documented
  • G9215Cd4+ cell count or percentage not documented as performed, reason not given
  • G9216Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given
  • G9217Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given
  • G9218Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given
  • G9219Pneumocystis 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)
  • G9220Pneumocystis 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)
  • G9221Pneumocystis jiroveci pneumonia prophlaxis prescribed
  • G9222Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
  • G9224Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)
  • G9229Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)
  • G9232Clinician 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)
  • G9233All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
  • G9234I intend to report the total knee replacement measures group
  • G9235All quality actions for the applicable measures in the general surgery measures group have been performed for this patient
  • G9236All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient
  • G9237I intend to report the general surgery measures group
  • G9238I intend to report the optimizing patient exposure to ionizing radiation measures group
  • G9239Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)
  • G9240Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated
  • G9241Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated
  • G9244Antiretroviral thereapy not prescribed
  • G9245Antiretroviral therapy prescribed
  • G9248Patient did not have a medical visit in the last 6 months
  • G9249Patient had a medical visit in the last 6 months
  • G9250Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment
  • G9251Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment
  • G9252Adenoma(s) or other neoplasm detected during screening colonoscopy
  • G9253Adenoma(s) or other neoplasm not detected during screening colonoscopy
  • G9256Documentation of patient death following cas
  • G9257Documentation of patient stroke following cas
  • G9258Documentation of patient stroke following cea
  • G9259Documentation of patient survival and absence of stroke following cas
  • G9260Documentation of patient death following cea
  • G9261Documentation of patient survival and absence of stroke following cea
  • G9262Documentation of patient death in the hospital following endovascular aaa repair
  • G9263Documentation of patient discharged alive following endovascular aaa repair
  • G9264Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)
  • G9265Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access
  • G9266Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access
  • G9267Documentation of patient with one or more complications or mortality within 30 days
  • G9268Documentation of patient with one or more complications within 90 days
  • G9269Documentation of patient without one or more complications and without mortality within 30 days
  • G9270Documentation of patient without one or more complications within 90 days
  • G9271Ldl value < 100
  • G9272Ldl value >= 100
  • G9300Documentation 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)
  • G9301Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
  • G9302Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given
  • G9303Operative 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
  • G9304Operative 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
  • G9320Documentation 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)
  • G9323Documentation 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)
  • G9324All necessary data elements not included, reason not given
  • G9325Ct 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)
  • G9326Ct 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
  • G9327Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements
  • G9328Dicom 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)
  • G9329Dicom 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
  • G9340Final 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
  • G9343Due 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)
  • G9346Follow-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)
  • G9348Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons
  • G9349Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
  • G9350Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis
  • G9359Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier
  • G9360No documentation of negative or managed positive tb screen
  • G9362Duration 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
  • G9363Duration 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
  • G9365One high-risk medication ordered
  • G9366One high-risk medication not ordered
  • G9369Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater
  • G9370Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater
  • G9376Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery
  • G9377Patient did not have the retina attached after 6 months following only one surgery
  • G9378Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)
  • G9379Patient did not achieve flat retinas six months post surgery
  • G9381Documentation 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
  • G9389Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
  • G9390No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
  • G9391Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
  • G9392Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
  • G9399Documentation 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
  • G9400Documentation 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
  • G9401No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment
  • G9402Patient received follow-up within 30 days after discharge
  • G9403Clinician 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)
  • G9404Patient did not receive follow-up within 30 days after discharge
  • G9405Patient received follow-up within 7 days after discharge
  • G9406Clinician 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)
  • G9407Patient did not receive follow-up within 7 days after discharge
  • G9433Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period
  • G9435Aspirin prescribed at discharge
  • G9436Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
  • G9437Aspirin not prescribed at discharge
  • G9438P2y inhibitor prescribed at discharge
  • G9439P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
  • G9440P2y inhibitor not prescribed at discharge
  • G9441Statin prescribed at discharge
  • G9442Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)
  • G9443Statin not prescribed at discharge
  • G9448Patients who were born in the years 1945 to 1965
  • G9449History of receiving blood transfusions prior to 1992
  • G9450History of injection drug use
  • G9451Patient received one-time screening for hcv infection
  • G9453Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)
  • G9454One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given
  • G9458Patient 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
  • G9459Currently a tobacco non-user
  • G9460Tobacco assessment or tobacco cessation intervention not performed, reason not given
  • G9463I intend to report the sinusitis measures group
  • G9464All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient
  • G9465I intend to report the acute otitis externa (aoe) measures group
  • G9466All quality actions for the applicable measures in the aoe measures group have been performed for this patient
  • G9467Patient 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
  • G9469Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills
  • G9472Within 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
  • G9496Documentation 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
  • G9499Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period
  • G9503Patient taking tamsulosin hydrochloride
  • G9506Biologic immune response modifier prescribed
  • G9523Patient discontinued from hemodialysis or peritoneal dialysis
  • G9524Patient was referred to hospice care
  • G9525Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
  • G9526Patient was not referred to hospice care, reason not given
  • G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
  • G9534Advanced brain imaging (cta, ct, mra or mri) was not ordered
  • G9535Patients with a normal neurological examination
  • G9536Documentation 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)
  • G9538Advanced brain imaging (cta, ct, mra or mri) was ordered
  • G9558Patient treated with a beta-lactam antibiotic as definitive therapy
  • G9559Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)
  • G9560Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given
  • G9561Patients prescribed opiates for longer than six weeks
  • G9562Patients who had a follow-up evaluation conducted at least every three months during opioid therapy
  • G9563Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy
  • G9572Index date phq-score greater than 9 documented during the twelve month denominator identification period
  • G9573Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five
  • G9574Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five
  • G9577Patients prescribed opiates for longer than six weeks
  • G9578Documentation of signed opioid treatment agreement at least once during opioid therapy
  • G9579No documentation of signed an opioid treatment agreement at least once during opioid therapy
  • G9581Door 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)
  • G9583Patients prescribed opiates for longer than six weeks
  • G9584Patient 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
  • G9585Patient 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
  • G9596Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
  • G9600Symptomatic aaas that required urgent/emergent (non-elective) repair
  • G9601Patient discharge to home no later than post-operative day #7
  • G9602Patient not discharged to home by post-operative day #7
  • G9604Patient survey results not available
  • G9612Photodocumentation of two or more cecal landmarks to establish a complete examination
  • G9613Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)
  • G9614Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination
  • G9615Preoperative assessment documented
  • G9616Documentation 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)
  • G9617Preoperative assessment not documented, reason not given
  • G9618Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind
  • G9619Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)
  • G9620Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given
  • G9623Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)
  • G9631Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
  • G9632Documented 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)
  • G9633Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery
  • G9634Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved
  • G9635Health-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)
  • G9636Health-related quality of life not assessed with tool during at least two visits or quality of life score declined
  • G9639Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure
  • G9640Documentation of planned hybrid or staged procedure
  • G9641Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure
  • G9647Patients in whom mrs score could not be obtained at 90 day follow-up
  • G9650Documentation 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
  • G9652Patient has been treated with a systemic or biologic medication for psoriasis for at least six months
  • G9653Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months
  • G9657Transfer of care during an anesthetic or to the intensive care unit
  • G9666Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl
  • G9667Documentation 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)
  • G9669I intend to report the multiple chronic conditions measures group
  • G9670All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient
  • G9671I intend to report the diabetic retinopathy measures group
  • G9672All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient
  • G9673I intend to report the cardiovascular prevention measures group
  • G9677All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient
  • G9678Oncology 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
  • G9686Onsite 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
  • G9697Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator
  • G9701Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established
  • G9707Patient received hospice services any time during the measurement period
  • G9715Patients who use hospice services any time during the measurement period
  • G9718Hospice services for patient provided any time during the measurement period
  • G9725Patients who use hospice services any time during the measurement period
  • G9738Patient refused to participate
  • G9739Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
  • G9742Psychiatric symptoms assessed
  • G9743Psychiatric symptoms not assessed, reason not otherwise specified
  • G9747Patient is undergoing palliative dialysis with a catheter
  • G9748Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
  • G9749Patient is undergoing palliative dialysis with a catheter
  • G9750Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
  • G9751Patient died at any time during the 24-month measurement period
  • G9759History of preoperative posterior capsule rupture
  • G9760Patients who use hospice services any time during the measurement period
  • G9774Patients who have had a hysterectomy
  • G9778Patients who have a diagnosis of pregnancy at any time during the measurement period
  • G9783Documentation 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
  • G9798Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period
  • G9799Patients 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
  • G9800Patients who are identified as having an intolerance or allergy to beta-blocker therapy
  • G9801Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis
  • G9802Patients who use hospice services any time during the measurement period
  • G9803Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
  • G9804Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
  • G9808Any patients who had no asthma controller medications dispensed during the measurement year
  • G9809Patients who use hospice services any time during the measurement period
  • G9810Patient achieved a pdc of at least 75% for their asthma controller medication
  • G9811Patient did not achieve a pdc of at least 75% for their asthma controller medication
  • G9814Death occurring during the index acute care hospitalization
  • G9815Death did not occur during the index acute care hospitalization
  • G9816Death occurring after discharge from the hospital but within 30 days post procedure
  • G9817Death did not occur after discharge from the hospital within 30 days post procedure
  • G9825Her-2/neu negative or undocumented/unknown
  • G9826Patient transferred to practice after initiation of chemotherapy
  • G9827Her2-targeted therapies not administered during the initial course of treatment
  • G9828Her2-targeted therapies administered during the initial course of treatment
  • G9829Breast adjuvant chemotherapy administered
  • G9833Patient transfer to practice after initiation of chemotherapy
  • G9834Patient has metastatic disease at diagnosis
  • G9835Trastuzumab administered within 12 months of diagnosis
  • G9836Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
  • G9837Trastuzumab not administered within 12 months of diagnosis
  • G9849Patients who died from cancer
  • G9850Patient had more than one emergency department visit in the last 30 days of life
  • G9851Patient had one or less emergency department visits in the last 30 days of life
  • G9852Patients who died from cancer
  • G9853Patient admitted to the icu in the last 30 days of life
  • G9854Patient was not admitted to the icu in the last 30 days of life
  • G9855Patients who died from cancer
  • G9856Patient was not admitted to hospice
  • G9857Patient admitted to hospice
  • G9892Documentation of patient reason(s) for not performing a dilated macular examination
  • G9893Dilated macular exam was not performed, reason not otherwise specified
  • G9904Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
  • G9907Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months (e.g., limited life expectancy, other medical reason)
  • G9909Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason)
  • G9921No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified
  • G9924Documentation 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)
  • G9927Documentation of system reason(s) for not prescribing an fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment
  • G9932Documentation 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)
  • G9933Adenoma(s) or colorectal cancer detected during screening colonoscopy
  • G9934Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
  • G9935Adenoma(s) or colorectal cancer not detected during screening colonoscopy
  • G9936Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
  • G9937Diagnostic colonoscopy
  • G9941Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
  • G9942Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
  • G9944Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
  • G9947Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
  • G9948Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
  • G9966Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
  • G9967Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
  • G9974Dilated 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
  • G9975Documentation of medical reason(s) for not performing a dilated macular examination
  • G9989Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., adverse reaction to vaccine)
  • G9990Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
  • G9991Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
  • G9995Patients who use palliative care services any time during the measurement period
HCPCS Level II2026Q3-Jul· effective July 1, 2026