QPP Measure #416
Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years
Percentage of emergency department visits for patients aged 2 through 17 years who presented within 24 hours of a minor blunt head trauma with a Glasgow Coma Scale (GCS) score of 15 and who had a head CT for trauma ordered by an emergency care provider who are classified as low risk according to the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules for traumatic brain injury
The following codes apply for this QPP measure:
CPT Codes | |||
| Code | Description | ||
|---|---|---|---|
| 99281 | CPT Code | ||
| 99282 | CPT Code | ||
| 99283 | CPT Code | ||
| 99284 | CPT Code | ||
| 99285 | CPT Code | ||
HCPCS Codes | |||
| Code | Description | ||
| G9593 | Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules | ||
| G9594 | Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider | ||
| G9595 | Patient has documentation of ventricular shunt, brain tumor, or coagulopathy | ||
| G9596 | Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma | ||
| G9597 | Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules | ||
ICD10CM Codes | |||
| Code | Description | ||
| S00.03XA | Contusion of scalp, initial encounter | ||
| S00.33XA | Contusion of nose, initial encounter | ||
| S00.431A | Contusion of right ear, initial encounter | ||
| S00.432A | Contusion of left ear, initial encounter | ||
| S00.439A | Contusion of unspecified ear, initial encounter | ||
| S00.531A | Contusion of lip, initial encounter | ||
| S00.532A | Contusion of oral cavity, initial encounter | ||
| S00.83XA | Contusion of other part of head, initial encounter | ||
| S00.93XA | Contusion of unspecified part of head, initial encounter | ||
| S02.0XXA | Fracture of vault of skull, initial encounter for closed fracture | ||
| S02.101A | Fracture of base of skull, right side, initial encounter for closed fracture | ||
| S02.102A | Fracture of base of skull, left side, initial encounter for closed fracture | ||
| S02.109A | Fracture of base of skull, unspecified side, initial encounter for closed fracture | ||
| S02.110A | Type I occipital condyle fracture, unspecified side, initial encounter for closed fracture | ||
| S02.111A | Type II occipital condyle fracture, unspecified side, initial encounter for closed fracture | ||
| S02.112A | Type III occipital condyle fracture, unspecified side, initial encounter for closed fracture | ||
| S02.113A | Unspecified occipital condyle fracture, initial encounter for closed fracture | ||
| S02.118A | Other fracture of occiput, unspecified side, initial encounter for closed fracture | ||
| S02.119A | Unspecified fracture of occiput, initial encounter for closed fracture | ||
| S02.11AA | Type I occipital condyle fracture, right side, initial encounter for closed fracture | ||
| S02.11BA | Type I occipital condyle fracture, left side, initial encounter for closed fracture | ||
| S02.11CA | Type II occipital condyle fracture, right side, initial encounter for closed fracture | ||
| S02.11DA | Type II occipital condyle fracture, left side, initial encounter for closed fracture | ||
| S02.11EA | Type III occipital condyle fracture, right side, initial encounter for closed fracture | ||
| S02.11FA | Type III occipital condyle fracture, left side, initial encounter for closed fracture | ||
| S02.11GA | Other fracture of occiput, right side, initial encounter for closed fracture | ||
| S02.11HA | Other fracture of occiput, left side, initial encounter for closed fracture | ||
| S02.19XA | Other fracture of base of skull, initial encounter for closed fracture | ||
| S02.2XXA | Fracture of nasal bones, initial encounter for closed fracture | ||
| S02.30XA | Fracture of orbital floor, unspecified side, initial encounter for closed fracture | ||
| S02.31XA | Fracture of orbital floor, right side, initial encounter for closed fracture | ||
| S02.32XA | Fracture of orbital floor, left side, initial encounter for closed fracture | ||
| S02.400A | Malar fracture, unspecified side, initial encounter for closed fracture | ||
| S02.401A | Maxillary fracture, unspecified side, initial encounter for closed fracture | ||
| S02.402A | Zygomatic fracture, unspecified side, initial encounter for closed fracture | ||
| S02.40AA | Malar fracture, right side, initial encounter for closed fracture | ||
| S02.40BA | Malar fracture, left side, initial encounter for closed fracture | ||
| S02.40CA | Maxillary fracture, right side, initial encounter for closed fracture | ||
| S02.40DA | Maxillary fracture, left side, initial encounter for closed fracture | ||
| S02.40EA | Zygomatic fracture, right side, initial encounter for closed fracture | ||
| S02.40FA | Zygomatic fracture, left side, initial encounter for closed fracture | ||
| S02.411A | LeFort I fracture, initial encounter for closed fracture | ||
| S02.412A | LeFort II fracture, initial encounter for closed fracture | ||
| S02.413A | LeFort III fracture, initial encounter for closed fracture | ||
| S02.42XA | Fracture of alveolus of maxilla, initial encounter for closed fracture | ||
| S02.600A | Fracture of unspecified part of body of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.601A | Fracture of unspecified part of body of right mandible, initial encounter for closed fracture | ||
| S02.602A | Fracture of unspecified part of body of left mandible, initial encounter for closed fracture | ||
| S02.609A | Fracture of mandible, unspecified, initial encounter for closed fracture | ||
| S02.610A | Fracture of condylar process of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.611A | Fracture of condylar process of right mandible, initial encounter for closed fracture | ||
| S02.612A | Fracture of condylar process of left mandible, initial encounter for closed fracture | ||
| S02.620A | Fracture of subcondylar process of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.621A | Fracture of subcondylar process of right mandible, initial encounter for closed fracture | ||
| S02.622A | Fracture of subcondylar process of left mandible, initial encounter for closed fracture | ||
| S02.630A | Fracture of coronoid process of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.631A | Fracture of coronoid process of right mandible, initial encounter for closed fracture | ||
| S02.632A | Fracture of coronoid process of left mandible, initial encounter for closed fracture | ||
| S02.640A | Fracture of ramus of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.641A | Fracture of ramus of right mandible, initial encounter for closed fracture | ||
| S02.642A | Fracture of ramus of left mandible, initial encounter for closed fracture | ||
| S02.650A | Fracture of angle of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.651A | Fracture of angle of right mandible, initial encounter for closed fracture | ||
| S02.652A | Fracture of angle of left mandible, initial encounter for closed fracture | ||
| S02.66XA | Fracture of symphysis of mandible, initial encounter for closed fracture | ||
| S02.670A | Fracture of alveolus of mandible, unspecified side, initial encounter for closed fracture | ||
| S02.671A | Fracture of alveolus of right mandible, initial encounter for closed fracture | ||
| S02.672A | Fracture of alveolus of left mandible, initial encounter for closed fracture | ||
| S02.69XA | Fracture of mandible of other specified site, initial encounter for closed fracture | ||
| S02.80XA | Fracture of other specified skull and facial bones, unspecified side, initial encounter for closed fracture | ||
| S02.81XA | Fracture of other specified skull and facial bones, right side, initial encounter for closed fracture | ||
| S02.82XA | Fracture of other specified skull and facial bones, left side, initial encounter for closed fracture | ||
| S02.91XA | Unspecified fracture of skull, initial encounter for closed fracture | ||
| S02.92XA | Unspecified fracture of facial bones, initial encounter for closed fracture | ||
| S06.0X0A | Concussion without loss of consciousness, initial encounter | ||
| S06.0X1A | Concussion with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.0X2A | Concussion with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.0X3A | Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.0X4A | Concussion with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.0X9A | Concussion with loss of consciousness of unspecified duration, initial encounter | ||
| S06.1X0A | Traumatic cerebral edema without loss of consciousness, initial encounter | ||
| S06.1X1A | Traumatic cerebral edema with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.1X2A | Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.1X3A | Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.1X4A | Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.1X9A | Traumatic cerebral edema with loss of consciousness of unspecified duration, initial encounter | ||
| S06.2X0A | Diffuse traumatic brain injury without loss of consciousness, initial encounter | ||
| S06.2X1A | Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.2X2A | Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.2X3A | Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.2X4A | Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.2X9A | Diffuse traumatic brain injury with loss of consciousness of unspecified duration, initial encounter | ||
| S06.300A | Unspecified focal traumatic brain injury without loss of consciousness, initial encounter | ||
| S06.301A | Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.302A | Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.303A | Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.304A | Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.309A | Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, initial encounter | ||
| S06.340A | Traumatic hemorrhage of right cerebrum without loss of consciousness, initial encounter | ||
| S06.341A | Traumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.342A | Traumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.343A | Traumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter | ||
| S06.344A | Traumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.349A | Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, initial encounter | ||
| S06.350A | Traumatic hemorrhage of left cerebrum without loss of consciousness, initial encounter | ||
| S06.351A | Traumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.352A | Traumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.353A | Traumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter | ||
| S06.354A | Traumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.359A | Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, initial encounter | ||
| S06.360A | Traumatic hemorrhage of cerebrum, unspecified, without loss of consciousness, initial encounter | ||
| S06.361A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.362A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.363A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter | ||
| S06.364A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.369A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter | ||
| S06.4X0A | Epidural hemorrhage without loss of consciousness, initial encounter | ||
| S06.4X1A | Epidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.4X2A | Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.4X3A | Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.4X4A | Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.4X9A | Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter | ||
| S06.5X0A | Traumatic subdural hemorrhage without loss of consciousness, initial encounter | ||
| S06.5X1A | Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.5X2A | Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.5X3A | Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.5X4A | Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.5X9A | Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter | ||
| S06.6X0A | Traumatic subarachnoid hemorrhage without loss of consciousness, initial encounter | ||
| S06.6X1A | Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.6X2A | Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.6X3A | Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.6X4A | Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.6X9A | Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial encounter | ||
| S06.810A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter | ||
| S06.811A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.812A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.813A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.814A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.819A | Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter | ||
| S06.820A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter | ||
| S06.821A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.822A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.823A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.824A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.829A | Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter | ||
| S06.890A | Other specified intracranial injury without loss of consciousness, initial encounter | ||
| S06.891A | Other specified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.892A | Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.893A | Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.894A | Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.899A | Other specified intracranial injury with loss of consciousness of unspecified duration, initial encounter | ||
| S06.9X0A | Unspecified intracranial injury without loss of consciousness, initial encounter | ||
| S06.9X1A | Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter | ||
| S06.9X2A | Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter | ||
| S06.9X3A | Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter | ||
| S06.9X4A | Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter | ||
| S06.9X9A | Unspecified intracranial injury with loss of consciousness of unspecified duration, initial encounter | ||
| S09.10XA | Unspecified injury of muscle and tendon of head, initial encounter | ||
| S09.11XA | Strain of muscle and tendon of head, initial encounter | ||
| S09.19XA | Other specified injury of muscle and tendon of head, initial encounter | ||
| S09.8XXA | Other specified injuries of head, initial encounter | ||
| S09.90XA | Unspecified injury of head, initial encounter | ||
| S09.92XA | Unspecified injury of nose, initial encounter | ||
| S09.93XA | Unspecified injury of face, initial encounter | ||
| S10.0XXA | Contusion of throat, initial encounter | ||
| S10.83XA | Contusion of other specified part of neck, initial encounter | ||
| S10.93XA | Contusion of unspecified part of neck, initial encounter | ||
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