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HCPCS Procedure & Supply Codes

Temporary Procedures & Professional Services

section notes

Quality Reporting Codes

section notes
G0029‑G0030   Tobacco screenings — Performed or not performed
G0031‑G9996   Palliative and hospice care
G0032‑G0033   Perscriptions ordered for behavioral health diagnosis
G0035   Patient has any emergency department encounter during the performance period wit...
G0036‑G0037   Assessments — declined or unable to participate
G0038‑G0041   Referrals — Not required, not referred, or declined
G0040‑G0042   Therapy (physical, occupational, speech, recreational) — Receiving or Referred
G0043   Patients with mechanical prosthetic heart valve
G0044   Patients with moderate or severe mitral stenosis
G0045‑G0046   Clinical follow-up with/without 90 day assessment following endovascular stroke intervention
G0047   Pediatric patient with minor blunt head trauma and pecarn prediction criteria ar...
G0049   With maintenance hemodialysis (in-center and home hd) for the complete reporting...
G0050   Patients with a catheter that have limited life expectancy
G0052   Patients on peritoneal dialysis for any portion of the reporting month
G0053‑G0059   MIPS value pathways
G0060‑G4038   MIPS Specialty Set
G0913   Improvement in visual function achieved within 90 days following cataract surgery
G0914   Patient care survey was not completed by patient
G0915   Improvement in visual function not achieved within 90 days following cataract surgery
G0916   Satisfaction with care achieved within 90 days following cataract surgery
G0917   Patient care survey was not completed by patient
G0918   Satisfaction with care not achieved within 90 days following cataract surgery
G1025   Patient-months where there are more than one medicare capitated payment (mcp) pr...
G1026   The number of adult patient-months in the denominator who were on maintenance he...
G1027   The number of adult patient-months in the denominator who were on maintenance he...
G2022   A model participant (ambulance supplier/provider), the beneficiary refuses servi...
G2081   Patients age 66 and older in institutional special needs plans (snp) or residing...
G2090‑G2127   Patients 66 Years and Older Documented Condition(s)
G2092‑G2096   Angiotencin (ACE or ARB) Inhibitor Documentation
G2097   Episodes where the patient had a competing diagnosis on or within three days aft...
G2112   Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is wor...
G2113   Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 month...
G2121   Depression, anxiety, apathy, and psychosis assessed
G2122   Depression, anxiety, apathy, and psychosis not assessed
G2128   Documentation of medical reason(s) for not on a daily aspirin or other antiplate...
G2129   Procedure-related bp's not taken during an outpatient visit. examples include sa...
G2136‑G9949   Pain Measured by the Visual Analog Scale (VAS)
G2142‑G2145   Functional Status Measured by the Oswestry Disability Index
G2148‑G2150   Documentation - Multimodal Pain Management
G2151   Documentation stating patient has a diagnosis of a degenerative neurological con...
G2152‑G2210   Residual score for the neck impairment
G2173   Uri episodes where the patient had a comorbid condition during the 12 months pri...
G2174   Uri episodes where the patient is taking antibiotics (table 1) in the 30 days pr...
G2175   Episodes where the patient had a comorbid condition during the 12 months prior t...
G2176   Outpatient, ed, or observation visits that result in an inpatient admission
G2177   Acute bronchitis/bronchiolitis episodes when the patient had a new or refill pre...
G2178   Clinician documented that patient was not an eligible candidate for lower extrem...
G2179   Clinician documented that patient had medical reason for not performing lower ex...
G2180   Clinician documented that patient was not an eligible candidate for evaluation o...
G2181   Bmi not documented due to medical reason or patient refusal of height or weight ...
G2182   Patient receiving first-time biologic and/or immune response modifier therapy
G2183   Documentation patient unable to communicate and informant not available
G2184   Patient does not have a caregiver
G2185   Documentation caregiver is trained and certified in dementia care
G2186   Patient /caregiver dyad has been referred to appropriate resources and connectio...
G2187‑G2195   Patients with Clinical Indications for Imaging of the Head
G2196‑G2200   Unhealthy Alcohol Use Screenings
G2199   Patient not screened for unhealthy alcohol use using a systematic screening method
G2202   Patient did not receive brief counseling if identified as an unhealthy alcohol user
G2204   Patients between 45 and 85 years of age who received a screening colonoscopy dur...
G2205‑G2208   Adjuvant Treatment Course
G2207   Reason for not administering adjuvant treatment course including both chemothera...
G2209   Patient refused to participate
G8395‑G8934   Left Ventricular Ejection Fraction (LVEF)
G8397‑G8397   Dilated Macular or Fundus Exam
G8399   Patient with documented results of a central dual-energy x-ray absorptiometry (d...
G8400‑G8484   G8400-G8499
G8510‑G8599   G8500-G8599
G8600‑G9663   G8600-G9663
G8633‑G9965   Measure Groups for Quality Payment Program
G8708‑G8798   G8700-G8798
G8806‑G8817   Procedures/Tests Documented/Not Documented
G8826‑G8882   G8818-G8897
G8907‑G8915   Patient Documented.....
G8916‑G8918   Patient with or without Preoperative Order for IV Antibiotic SSI Prophylaxis
G8924‑G8924   Spirometry test results
G8935‑G8937   ACE/ARB Therapy
G8942   Functional outcome assessment using a standardized tool is documented within the...
G8944   Ajcc melanoma cancer stage 0 through iic melanoma
G8946   Minimally invasive biopsy method attempted but not diagnostic of breast cancer (...
G8950‑G8952   Pre-Hypertension or Hypertension BP Reading with or w/out Follow-up plan
G8955   Most recent assessment of adequacy of volume management documented
G8956‑G8956   Hemodialysis in an Outpatient Dialysis Facility
G8958   Assessment of adequacy of volume management not documented, reason not given
G8961‑G8966   Cardiac Stress Imaging Test
G8967‑G8969   Warfarin or Oral Anticoagulant Prescribed or Not Prescribed
G8970‑G8970   Thromboembolism Risks
G9001‑G9011   Coordinated Care Fee
G9012   Other specified case management service not elsewhere classified
G9013‑G9014   ESRD Demo Bundle
G9016   Smoking cessation counseling, individual, in the absence of or in addition to an...
G9143‑G9928   Warfarin and/or Other FDA-Approved Anti-Coagulation
G9148‑G9150   National Committee for Quality Assurance
G9151‑G9153   MAPCP Demonstration
G9187   Bundled payments for care improvement initiative home visit for patient assessme...
G9188‑G9191   Beta-blocker therapy
G9212   Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation
G9213   Dsm-iv-tr criteria for major depressive disorder not documented at the initial e...
G9223‑G9223   Pneumocystis jiroveci pneumonia prophylaxis
G9225‑G9226   Foot Exam
G9227   Functional outcome assessment documented, care plan not documented, documentatio...
G9228‑G9230   Chlamydia, gonorrhea, and syphilis
G9231   Documentation of end stage renal disease (esrd), dialysis, renal transplant befo...
G9242   Documentation of viral load equal to or greater than 200 copies/ml or viral load...
G9243   Documentation of viral load less than 200 copies/ml
G9246‑G9247   Last medical visit
G9254   Documentation of patient discharged to home later than post-operative day 2 foll...
G9255   Documentation of patient discharged to home no later than post operative day 2 f...
G9273   Blood pressure has a systolic value of < 140 and a diastolic value of < 90
G9274   Blood pressure has a systolic value of =140 and a diastolic value of = 90 or sys...
G9275   Documentation that patient is a current non-tobacco user
G9276   Documentation that patient is a current tobacco user
G9277   Documentation that the patient is on daily aspirin or anti-platelet or has docum...
G9278   Documentation that the patient is not on daily aspirin or anti-platelet regimen
G9279‑G9991   Vaccination Status
G9282   Documentation of medical reason(s) for not reporting the histological type or ns...
G9283   Non small cell lung cancer biopsy and cytology specimen report documents classif...
G9284   Non small cell lung cancer biopsy and cytology specimen report does not document...
G9285   Specimen site other than anatomic location of lung or is not classified as non s...
G9286   Antibiotic regimen prescribed within 10 days after onset of symptoms
G9287   Antibiotic regimen not prescribed within 10 days after onset of symptoms
G9288   Documentation of medical reason(s) for not reporting the histological type or ns...
G9289   Non small cell lung cancer biopsy and cytology specimen report documents classif...
G9290   Non small cell lung cancer biopsy and cytology specimen report does not document...
G9291   Specimen site other than anatomic location of lung, is not classified as non sma...
G9292   Documentation of medical reason(s) for not reporting pt category and a statement...
G9293   Pathology report does not include the pt category and a statement on thickness a...
G9294   Pathology report includes the pt category and a statement on thickness and ulcer...
G9295   Specimen site other than anatomic cutaneous location
G9296   Patients with documented shared decision-making including discussion of conserva...
G9297   Shared decision-making including discussion of conservative (non-surgical) thera...
G9298   Patients who are evaluated for venous thromboembolic and cardiovascular risk fac...
G9299   Patients who are not evaluated for venous thromboembolic and cardiovascular risk...
G9305   Intervention for presence of leak of endoluminal contents through an anastomosis...
G9306   Intervention for presence of leak of endoluminal contents through an anastomosis...
G9307   No return to the operating room for a surgical procedure, for complications of t...
G9308   Unplanned return to the operating room for a surgical procedure, for complicatio...
G9309   No unplanned hospital readmission within 30 days of principal procedure
G9310   Unplanned hospital readmission within 30 days of principal procedure
G9311   No surgical site infection
G9312   Surgical site infection
G9313‑G9315   Amoxicillin, with or without clavulanate prescription status
G9316   Documentation of patient-specific risk assessment with a risk calculator based o...
G9317   Documentation of patient-specific risk assessment with a risk calculator based o...
G9318‑G9322   Imaging study status
G9351‑G9354   CT Scan, Paranasal Sinuses Status
G9357‑G9358   Post-partum screenings, evaluations and education
G9361   Medical indication for delivery by cesarean birth or induction of labor (<39 wee...
G9364   Sinusitis caused by, or presumed to be caused by, bacterial infection
G9367‑G9368   High Risk Medications Prescribed
G9393   Patient with an initial phq-9 score greater than nine who achieves remission at ...
G9394   Patient who had a diagnosis of bipolar disorder or personality disorder, death, ...
G9395   Patient with an initial phq-9 score greater than nine who did not achieve remiss...
G9396   Patient with an initial phq-9 score greater than nine who was not assessed for r...
G9426   Improvement in median time from ed arrival to initial ed oral or parenteral pain...
G9427   Improvement in median time from ed arrival to initial ed oral or parenteral pain...
G9468   Patient not receiving corticosteroids greater than or equal to 10 mg/day of pred...
G9470   Patients not receiving corticosteroids greater than or equal to 10 mg/day of pre...
G9471   Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not orde...
G9498   Antibiotic regimen prescribed
G9500   Radiation exposure indices documented in final report for procedure using fluoroscopy
G9501   Radiation exposure indices not documented in final report for procedure using fl...
G9502   Documentation of medical reason for not performing foot exam (i.e., patients who...
G9504   Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patien...
G9505   Antibiotic regimen prescribed within 10 days after onset of symptoms for documen...
G9507   Documentation that the patient is on a statin medication or has documentation of...
G9508   Documentation that the patient is not on a statin medication
G9553   Prior thyroid disease diagnosis
G9557   Final reports for ct, cta, mri or mra studies of the chest or neck without an in...
G9598   Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or mino...
G9599   Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or...
G9674   Patients with clinical ascvd diagnosis
G9675   Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
G9676   Patients aged 40 to 75 years at the beginning of the measurement period with typ...
G9687‑G9720   Hospice Care
G9689   Patient admitted for performance of elective carotid intervention
G9694   Hospice services utilized by patient any time during the measurement period
G9695   Long-acting inhaled bronchodilator prescribed
G9696‑G9698   Documentation of reason(s) for not prescribing a long-acting inhaled bronchodilator
G9699   Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified
G9700   Patients who use hospice services any time during the measurement period
G9703   Episodes where the patient is taking antibiotics (table 1) in the 30 days prior ...
G9704   Ajcc breast cancer stage i: t1 mic or t1a documented
G9705   Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimensio...
G9706   Low (or very low) risk of recurrence, prostate cancer
G9707   Patient received hospice services any time during the measurement period
G9708   Women who had a bilateral mastectomy or who have a history of a bilateral mastec...
G9709   Hospice services used by patient any time during the measurement period
G9710   Patient was provided hospice services any time during the measurement period
G9711   Patients with a diagnosis or past history of total colectomy or colorectal cancer
G9712   Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g...
G9713   Patients who use hospice services any time during the measurement period
G9714   Patient is using hospice services any time during the measurement period
G9716   Bmi is documented as being outside of normal parameters, follow-up plan is not c...
G9717   Documentation stating the patient has had a diagnosis of bipolar disorder
G9719   Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair b...
G9721   Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair boun...
G9722   Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; r...
G9723   Hospice services for patient received any time during the measurement period
G9724   Patients who had documentation of use of anticoagulant medications overlapping t...
G9726   Patient refused to participate
G9727‑G9737   Patient Inability to Complete Evaluation
G9728‑G9736   Patient refused to participate
G9740   Hospice services given to patient any time during the measurement period
G9741   Patients who use hospice services any time during the measurement period
G9744   Patient not eligible due to active diagnosis of hypertension
G9745   Documented reason for not screening or recommending a follow-up for high blood p...
G9746   Patient has mitral stenosis or prosthetic heart valves or patient has transient ...
G9751   Patient died at any time during the 24-month measurement period
G9752   Emergency surgery
G9760   Patients who use hospice services any time during the measurement period
G9781   Documentation of medical reason(s) for not currently being a statin therapy user...
G9785   Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcin...
G9786   Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcin...
G9848   Patient did not receive systemic cancer-directed therapy in the last 14 days of life
G9862‑G9862   Colonoscopy
G9888   Maintenance 5% wl from baseline weight in months 7-12
G9892‑G9893   DIlated Macular Examination
G9894‑G9897   Prostate Therapy
G9898   Patients age 66 or older in institutional special needs plans (snp) or residing ...
G9899‑G9900   Mammography Screening Results
G9901   Patient age 66 or older in institutional special needs plans (snp) or residing i...
G9902‑G9908   Tobacco Screening, Use & Cessation Intervention
G9910   Patients age 66 or older in institutional special needs plans (snp) or residing ...
G9911   Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or aft...
G9912‑G9915   Hepatitis b Virus (hbv) Status
G9916‑G9918   Functional Status
G9917   Documentation of advanced stage dementia and caregiver knowledge is limited
G9919‑G9926   Screenings
G9929   Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidi...
G9930   Patients who are receiving comfort care only
G9931   Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women
G9938   Patients aged 66 or older in institutional special needs plans (snp) or residing...
G9939   Pathologists/dermatopathologists is the same clinician who performed the biopsy
G9940   Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitr...
G9945   Patient had cancer, acute fracture or infection related to the lumbar spine or p...
G9968‑G9970   Provider Referrals
G9974‑G9975   Dilated Macular Examination
G9997   Documentation of patient pregnancy anytime during the measurement period prior t...
G9998‑G9999   Documentation for interval of less than 3 yrs since last colonoscopy
 Test results with No Follow Up Plan - Not eligible or not documented
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