HCPCS Code: G0008
Short Description: Admin influenza virus vac
Long Description: Administration of influenza virus vaccine
HCPCS Code: G0009
Short Description: Admin pneumococcal vaccine
Long Description: Administration of pneumococcal vaccine
HCPCS Code: G0010
Short Description: Admin hepatitis b vaccine
Long Description: Administration of hepatitis b vaccine
HCPCS Code: G0027
Short Description: Semen analysis
Long Description: Semen analysis; presence and/or motility of sperm excluding huhner
HCPCS Code: G0101
Short Description: Ca screen;pelvic/breast exam
Long Description: Cervical or vaginal cancer screening; pelvic and clinical breast examination
HCPCS Code: G0102
Short Description: Prostate ca screening; dre
Long Description: Prostate cancer screening; digital rectal examination
HCPCS Code: G0103
Short Description: Psa screening
Long Description: Prostate cancer screening; prostate specific antigen test (psa)
HCPCS Code: G0104
Short Description: Ca screen;flexi sigmoidscope
Long Description: Colorectal cancer screening; flexible sigmoidoscopy
HCPCS Code: G0105
Short Description: Colorectal scrn; hi risk ind
Long Description: Colorectal cancer screening; colonoscopy on individual at high risk
HCPCS Code: G0106
Short Description: Colon ca screen;barium enema
Long Description: Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
HCPCS Code: G0108
Short Description: Diab manage trn per indiv
Long Description: Diabetes outpatient self-management training services, individual, per 30 minutes
HCPCS Code: G0109
Short Description: Diab manage trn ind/group
Long Description: Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
HCPCS Code: G0117
Short Description: Glaucoma scrn hgh risk direc
Long Description: Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
HCPCS Code: G0118
Short Description: Glaucoma scrn hgh risk direc
Long Description: Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
HCPCS Code: G0120
Short Description: Colon ca scrn; barium enema
Long Description: Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
HCPCS Code: G0121
Short Description: Colon ca scrn not hi rsk ind
Long Description: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
HCPCS Code: G0122
Short Description: Colon ca scrn; barium enema
Long Description: Colorectal cancer screening; barium enema
HCPCS Code: G0123
Short Description: Screen cerv/vag thin layer
Long Description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
HCPCS Code: G0124
Short Description: Screen c/v thin layer by md
Long Description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
HCPCS Code: G0127
Short Description: Trim nail(s)
Long Description: Trimming of dystrophic nails, any number
HCPCS Code: G0128
Short Description: Corf skilled nursing service
Long Description: Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes
HCPCS Code: G0129
Short Description: Partial hosp prog service
Long Description: Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)
HCPCS Code: G0130
Short Description: Single energy x-ray study
Long Description: Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
HCPCS Code: G0141
Short Description: Scr c/v cyto,autosys and md
Long Description: Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
HCPCS Code: G0143
Short Description: Scr c/v cyto,thinlayer,rescr
Long Description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
HCPCS Code: G0144
Short Description: Scr c/v cyto,thinlayer,rescr
Long Description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
HCPCS Code: G0145
Short Description: Scr c/v cyto,thinlayer,rescr
Long Description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
HCPCS Code: G0147
Short Description: Scr c/v cyto, automated sys
Long Description: Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
HCPCS Code: G0148
Short Description: Scr c/v cyto, autosys, rescr
Long Description: Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
HCPCS Code: G0151
Short Description: Hhcp-serv of pt,ea 15 min
Long Description: Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes
HCPCS Code: G0152
Short Description: Hhcp-serv of ot,ea 15 min
Long Description: Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes
HCPCS Code: G0153
Short Description: Hhcp-svs of s/l path,ea 15mn
Long Description: Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes
HCPCS Code: G0154
Short Description: Hhcp-svs of rn,ea 15 min
Long Description: Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes
HCPCS Code: G0155
Short Description: Hhcp-svs of csw,ea 15 min
Long Description: Services of clinical social worker in home health or hospice settings, each 15 minutes
HCPCS Code: G0156
Short Description: Hhcp-svs of aide,ea 15 min
Long Description: Services of home health/hospice aide in home health or hospice settings, each 15 minutes
HCPCS Code: G0157
Short Description: Hhc pt assistant ea 15
Long Description: Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes
HCPCS Code: G0158
Short Description: Hhc ot assistant ea 15
Long Description: Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes
HCPCS Code: G0159
Short Description: Hhc pt maint ea 15 min
Long Description: Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes
HCPCS Code: G0160
Short Description: Hhc occup therapy ea 15
Long Description: Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
HCPCS Code: G0161
Short Description: Hhc slp ea 15 min
Long Description: Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes
HCPCS Code: G0162
Short Description: Hhc rn e&m plan svs, 15 min
Long Description: Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)
HCPCS Code: G0163
Short Description: Hhc lpn/rn obs/asses ea 15
Long Description: Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
HCPCS Code: G0164
Short Description: Hhc lis nurse train ea 15
Long Description: Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
HCPCS Code: G0166
Short Description: Extrnl counterpulse, per tx
Long Description: External counterpulsation, per treatment session
HCPCS Code: G0168
Short Description: Wound closure by adhesive
Long Description: Wound closure utilizing tissue adhesive(s) only
HCPCS Code: G0173
Short Description: Linear acc stereo radsur com
Long Description: Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session
HCPCS Code: G0175
Short Description: Opps service,sched team conf
Long Description: Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present
HCPCS Code: G0176
Short Description: Opps/php;activity therapy
Long Description: Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
HCPCS Code: G0177
Short Description: Opps/php; train & educ serv
Long Description: Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)
HCPCS Code: G0179
Short Description: Md recertification hha pt
Long Description: Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per re-certification period
HCPCS Code: G0180
Short Description: Md certification hha patient
Long Description: Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per certification period
HCPCS Code: G0181
Short Description: Home health care supervision
Long Description: Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
HCPCS Code: G0182
Short Description: Hospice care supervision
Long Description: Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more
HCPCS Code: G0186
Short Description: Dstry eye lesn,fdr vssl tech
Long Description: Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)
HCPCS Code: G0202
Short Description: Scr mammo bi incl cad
Long Description: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
HCPCS Code: G0204
Short Description: Dx mammo incl cad bi
Long Description: Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
HCPCS Code: G0206
Short Description: Dx mammo incl cad uni
Long Description: Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
HCPCS Code: G0219
Short Description: Pet img wholbod melano nonco
Long Description: Pet imaging whole body; melanoma for non-covered indications
HCPCS Code: G0235
Short Description: Pet not otherwise specified
Long Description: Pet imaging, any site, not otherwise specified
HCPCS Code: G0237
Short Description: Therapeutic procd strg endur
Long Description: Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
HCPCS Code: G0238
Short Description: Oth resp proc, indiv
Long Description: Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
HCPCS Code: G0239
Short Description: Oth resp proc, group
Long Description: Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
HCPCS Code: G0245
Short Description: Initial foot exam pt lops
Long Description: Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education
HCPCS Code: G0246
Short Description: Followup eval of foot pt lop
Long Description: Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
HCPCS Code: G0247
Short Description: Routine footcare pt w lops
Long Description: Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
HCPCS Code: G0248
Short Description: Demonstrate use home inr mon
Long Description: Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
HCPCS Code: G0249
Short Description: Provide inr test mater/equip
Long Description: Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests
HCPCS Code: G0250
Short Description: Md inr test revie inter mgmt
Long Description: Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests
HCPCS Code: G0251
Short Description: Linear acc based stero radio
Long Description: Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment
HCPCS Code: G0252
Short Description: Pet imaging initial dx
Long Description: Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
HCPCS Code: G0255
Short Description: Current percep threshold tst
Long Description: Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve
HCPCS Code: G0257
Short Description: Unsched dialysis esrd pt hos
Long Description: Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility
HCPCS Code: G0259
Short Description: Inject for sacroiliac joint
Long Description: Injection procedure for sacroiliac joint; arthrography
HCPCS Code: G0260
Short Description: Inj for sacroiliac jt anesth
Long Description: Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
HCPCS Code: G0268
Short Description: Removal of impacted wax md
Long Description: Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
HCPCS Code: G0269
Short Description: Occlusive device in vein art
Long Description: Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)
HCPCS Code: G0270
Short Description: Mnt subs tx for change dx
Long Description: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
HCPCS Code: G0271
Short Description: Group mnt 2 or more 30 mins
Long Description: Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
HCPCS Code: G0276
Short Description: Pild/placebo control clin tr
Long Description: Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial
HCPCS Code: G0277
Short Description: Hbot, full body chamber, 30m
Long Description: Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
HCPCS Code: G0278
Short Description: Iliac art angio,cardiac cath
Long Description: Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)
HCPCS Code: G0279
Short Description: Tomosynthesis, mammo
Long Description: Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to g0204 or g0206)
HCPCS Code: G0281
Short Description: Elec stim unattend for press
Long Description: Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
HCPCS Code: G0282
Short Description: Elect stim wound care not pd
Long Description: Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281
HCPCS Code: G0283
Short Description: Elec stim other than wound
Long Description: Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
HCPCS Code: G0288
Short Description: Recon, cta for surg plan
Long Description: Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
HCPCS Code: G0289
Short Description: Arthro, loose body + chondro
Long Description: Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
HCPCS Code: G0293
Short Description: Non-cov surg proc,clin trial
Long Description: Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day
HCPCS Code: G0294
Short Description: Non-cov proc, clinical trial
Long Description: Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day
HCPCS Code: G0295
Short Description: Electromagnetic therapy onc
Long Description: Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses
HCPCS Code: G0296
Short Description: Visit to determ ldct elig
Long Description: Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
HCPCS Code: G0297
Short Description: Ldct for lung ca screen
Long Description: Low dose ct scan (ldct) for lung cancer screening
HCPCS Code: G0299
Short Description: Hhs/hospice of rn ea 15 min
Long Description: Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes
HCPCS Code: G0300
Short Description: Hhs/hospice of lpn ea 15 min
Long Description: Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes
HCPCS Code: G0302
Short Description: Pre-op service lvrs complete
Long Description: Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
HCPCS Code: G0303
Short Description: Pre-op service lvrs 10-15dos
Long Description: Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
HCPCS Code: G0304
Short Description: Pre-op service lvrs 1-9 dos
Long Description: Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
HCPCS Code: G0305
Short Description: Post op service lvrs min 6
Long Description: Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
HCPCS Code: G0306
Short Description: Cbc/diffwbc w/o platelet
Long Description: Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
HCPCS Code: G0307
Short Description: Cbc without platelet
Long Description: Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
HCPCS Code: G0328
Short Description: Fecal blood scrn immunoassay
Long Description: Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous
HCPCS Code: G0329
Short Description: Electromagntic tx for ulcers
Long Description: Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
HCPCS Code: G0333
Short Description: Dispense fee initial 30 day
Long Description: Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary
HCPCS Code: G0337
Short Description: Hospice evaluation preelecti
Long Description: Hospice evaluation and counseling services, pre-election
HCPCS Code: G0339
Short Description: Robot lin-radsurg com, first
Long Description: Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
HCPCS Code: G0340
Short Description: Robt lin-radsurg fractx 2-5
Long Description: Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment
HCPCS Code: G0341
Short Description: Percutaneous islet celltrans
Long Description: Percutaneous islet cell transplant, includes portal vein catheterization and infusion
HCPCS Code: G0342
Short Description: Laparoscopy islet cell trans
Long Description: Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion
HCPCS Code: G0343
Short Description: Laparotomy islet cell transp
Long Description: Laparotomy for islet cell transplant, includes portal vein catheterization and infusion
HCPCS Code: G0364
Short Description: Bone marrow aspirate &biopsy
Long Description: Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
HCPCS Code: G0365
Short Description: Vessel mapping hemo access
Long Description: Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)
HCPCS Code: G0372
Short Description: Md service required for pmd
Long Description: Physician service required to establish and document the need for a power mobility device
HCPCS Code: G0378
Short Description: Hospital observation per hr
Long Description: Hospital observation service, per hour
HCPCS Code: G0379
Short Description: Direct refer hospital observ
Long Description: Direct admission of patient for hospital observation care
HCPCS Code: G0380
Short Description: Lev 1 hosp type b ed visit
Long Description: Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
HCPCS Code: G0381
Short Description: Lev 2 hosp type b ed visit
Long Description: Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
HCPCS Code: G0382
Short Description: Lev 3 hosp type b ed visit
Long Description: Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
HCPCS Code: G0383
Short Description: Lev 4 hosp type b ed visit
Long Description: Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
HCPCS Code: G0384
Short Description: Lev 5 hosp type b ed visit
Long Description: Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
HCPCS Code: G0389
Short Description: Ultrasound exam aaa screen
Long Description: Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
HCPCS Code: G0390
Short Description: Trauma respons w/hosp criti
Long Description: Trauma response team associated with hospital critical care service
HCPCS Code: G0396
Short Description: Alcohol/subs interv 15-30mn
Long Description: Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
HCPCS Code: G0397
Short Description: Alcohol/subs interv >30 min
Long Description: Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes
HCPCS Code: G0398
Short Description: Home sleep test/type 2 porta
Long Description: Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation
HCPCS Code: G0399
Short Description: Home sleep test/type 3 porta
Long Description: Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation
HCPCS Code: G0400
Short Description: Home sleep test/type 4 porta
Long Description: Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels
HCPCS Code: G0402
Short Description: Initial preventive exam
Long Description: Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
HCPCS Code: G0403
Short Description: Ekg for initial prevent exam
Long Description: Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
HCPCS Code: G0404
Short Description: Ekg tracing for initial prev
Long Description: Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
HCPCS Code: G0405
Short Description: Ekg interpret & report preve
Long Description: Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
HCPCS Code: G0406
Short Description: Inpt/tele follow up 15
Long Description: Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
HCPCS Code: G0407
Short Description: Inpt/tele follow up 25
Long Description: Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth
HCPCS Code: G0408
Short Description: Inpt/tele follow up 35
Long Description: Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth
HCPCS Code: G0409
Short Description: Corf related serv 15 mins ea
Long Description: Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)
HCPCS Code: G0410
Short Description: Grp psych partial hosp 45-50
Long Description: Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes
HCPCS Code: G0411
Short Description: Inter active grp psych parti
Long Description: Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes
HCPCS Code: G0412
Short Description: Open tx iliac spine uni/bil
Long Description: Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed
HCPCS Code: G0413
Short Description: Pelvic ring fracture uni/bil
Long Description: Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)
HCPCS Code: G0414
Short Description: Pelvic ring fx treat int fix
Long Description: Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)
HCPCS Code: G0415
Short Description: Open tx post pelvic fxcture
Long Description: Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)
HCPCS Code: G0416
Short Description: Prostate biopsy, any mthd
Long Description: Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
HCPCS Code: G0417
Short Description: Sat biopsy prostate 21-40
Long Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens
HCPCS Code: G0418
Short Description: Sat biopsy prostate 41-60
Long Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens
HCPCS Code: G0419
Short Description: Sat biopsy prostate: >60
Long Description: Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens
HCPCS Code: G0420
Short Description: Ed svc ckd ind per session
Long Description: Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
HCPCS Code: G0421
Short Description: Ed svc ckd grp per session
Long Description: Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
HCPCS Code: G0422
Short Description: Intens cardiac rehab w/exerc
Long Description: Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
HCPCS Code: G0423
Short Description: Intens cardiac rehab no exer
Long Description: Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
HCPCS Code: G0424
Short Description: Pulmonary rehab w exer
Long Description: Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
HCPCS Code: G0425
Short Description: Inpt/ed teleconsult30
Long Description: Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
HCPCS Code: G0426
Short Description: Inpt/ed teleconsult50
Long Description: Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
HCPCS Code: G0427
Short Description: Inpt/ed teleconsult70
Long Description: Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
HCPCS Code: G0428
Short Description: Collagen meniscus implant
Long Description: Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
HCPCS Code: G0429
Short Description: Dermal filler injection(s)
Long Description: Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
HCPCS Code: G0431
Short Description: Drug screen multiple class
Long Description: Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
HCPCS Code: G0432
Short Description: Eia hiv-1/hiv-2 screen
Long Description: Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening
HCPCS Code: G0433
Short Description: Elisa hiv-1/hiv-2 screen
Long Description: Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
HCPCS Code: G0434
Short Description: Drug screen multi drug class
Long Description: Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
HCPCS Code: G0435
Short Description: Oral hiv-1/hiv-2 screen
Long Description: Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
HCPCS Code: G0436
Short Description: Tobacco-use counsel 3-10 min
Long Description: Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
HCPCS Code: G0437
Short Description: Tobacco-use counsel>10min
Long Description: Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
HCPCS Code: G0438
Short Description: Ppps, initial visit
Long Description: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
HCPCS Code: G0439
Short Description: Ppps, subseq visit
Long Description: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
HCPCS Code: G0442
Short Description: Annual alcohol screen 15 min
Long Description: Annual alcohol misuse screening, 15 minutes
HCPCS Code: G0443
Short Description: Brief alcohol misuse counsel
Long Description: Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
HCPCS Code: G0444
Short Description: Depression screen annual
Long Description: Annual depression screening, 15 minutes
HCPCS Code: G0445
Short Description: High inten beh couns std 30m
Long Description: High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
HCPCS Code: G0446
Short Description: Intens behave ther cardio dx
Long Description: Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
HCPCS Code: G0447
Short Description: Behavior counsel obesity 15m
Long Description: Face-to-face behavioral counseling for obesity, 15 minutes
HCPCS Code: G0448
Short Description: Place perm pacing cardiovert
Long Description: Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing
HCPCS Code: G0451
Short Description: Devlopment test interpt&rep
Long Description: Development testing, with interpretation and report, per standardized instrument form
HCPCS Code: G0452
Short Description: Molecular pathology interpr
Long Description: Molecular pathology procedure; physician interpretation and report
HCPCS Code: G0453
Short Description: Cont intraop neuro monitor
Long Description: Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
HCPCS Code: G0454
Short Description: Md document visit by npp
Long Description: Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
HCPCS Code: G0455
Short Description: Fecal microbiota prep instil
Long Description: Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
HCPCS Code: G0456
Short Description: Neg pre wound <=50 sq cm
Long Description: Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters
HCPCS Code: G0457
Short Description: Neg pres wound >50 sq cm
Long Description: Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters
HCPCS Code: G0458
Short Description: Ldr prostate brachy comp rat
Long Description: Low dose rate (ldr) prostate brachytherapy services, composite rate
HCPCS Code: G0459
Short Description: Telehealth inpt pharm mgmt
Long Description: Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
HCPCS Code: G0460
Short Description: Autologous prp for ulcers
Long Description: Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment
HCPCS Code: G0461
Short Description: Immunohisto/cyto chem 1st st
Long Description: Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
HCPCS Code: G0462
Short Description: Immunohisto/cyto chem add
Long Description: Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)
HCPCS Code: G0463
Short Description: Hospital outpt clinic visit
Long Description: Hospital outpatient clinic visit for assessment and management of a patient
HCPCS Code: G0464
Short Description: Colorec ca scr, sto bas dna
Long Description: Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
HCPCS Code: G0466
Short Description: Fqhc visit new patient
Long Description: Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
HCPCS Code: G0467
Short Description: Fqhc visit, estab pt
Long Description: Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
HCPCS Code: G0468
Short Description: Fqhc visit, ippe or awv
Long Description: Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv
HCPCS Code: G0469
Short Description: Fqhc visit, mh new pt
Long Description: Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
HCPCS Code: G0470
Short Description: Fqhc visit, mh estab pt
Long Description: Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
HCPCS Code: G0471
Short Description: Ven blood coll snf/hha
Long Description: Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)
HCPCS Code: G0472
Short Description: Hep c screen high risk/other
Long Description: Hepatitis c antibody screening, for individual at high risk and other covered indication(s)
HCPCS Code: G0473
Short Description: Group behave couns 2-10
Long Description: Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
HCPCS Code: G0475
Short Description: Hiv combination assay
Long Description: Hiv antigen/antibody, combination assay, screening
HCPCS Code: G0476
Short Description: Hpv combo assay ca screen
Long Description: Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test
HCPCS Code: G0477
Short Description: Drug test presump optical
Long Description: Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
HCPCS Code: G0478
Short Description: Drug test presump opt inst
Long Description: Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
HCPCS Code: G0479
Short Description: Drug test presump not opt
Long Description: Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service
HCPCS Code: G0480
Short Description: Drug test def 1-7 classes
Long Description: Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed
HCPCS Code: G0481
Short Description: Drug test def 8-14 classes
Long Description: Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed
HCPCS Code: G0482
Short Description: Drug test def 15-21 classes
Long Description: Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed
HCPCS Code: G0483
Short Description: Drug test def 22+ classes
Long Description: Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed
HCPCS Code: G0490
Short Description: Home visit rn, lpn by rhc/fq
Long Description: Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)
HCPCS Code: G0491
Short Description: Dialysis acu kidney no esrd
Long Description: Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd
HCPCS Code: G0492
Short Description: Md/oth eval acut kid no esrd
Long Description: Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd
HCPCS Code: G0493
Short Description: Rn care ea 15 min hh/hospice
Long Description: Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
HCPCS Code: G0494
Short Description: Lpn care ea 15min hh/hospice
Long Description: Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
HCPCS Code: G0495
Short Description: Rn care train/edu in hh
Long Description: Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
HCPCS Code: G0496
Short Description: Lpn care train/edu in hh
Long Description: Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
HCPCS Code: G0498
Short Description: Chemo extend iv infus w/pump
Long Description: Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion
HCPCS Code: G0499
Short Description: Hepb screen high risk indiv
Long Description: Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag) followed by a neutralizing confirmatory test for initially reactive results, and antibodies to hbsag (anti-hbs) and hepatitis b core antigen (anti-hbc)
HCPCS Code: G0500
Short Description: Mod sedat endo service >5yrs
Long Description: Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
HCPCS Code: G0501
Short Description: Resource-inten svc during ov
Long Description: Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
HCPCS Code: G0502
Short Description: Init psych care manag, 70min
Long Description: Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies
HCPCS Code: G0503
Short Description: Subseq psych care man,60mi
Long Description: Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment
HCPCS Code: G0504
Short Description: Init/sub psych care add 30 m
Long Description: Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
HCPCS Code: G0505
Short Description: Cog/func assessment outpt
Long Description: Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
HCPCS Code: G0506
Short Description: Comp asses care plan ccm svc
Long Description: Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
HCPCS Code: G0507
Short Description: Care manage serv minimum 20
Long Description: Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team
HCPCS Code: G0508
Short Description: Crit care telehea consult 60
Long Description: Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
HCPCS Code: G0509
Short Description: Crit care telehea consult 50
Long Description: Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
HCPCS Code: G0511
Short Description: Ccm/bhi by rhc/fqhc 20min mo
Long Description: Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
HCPCS Code: G0512
Short Description: Cocm by rhc/fqhc 60 min mo
Long Description: Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
HCPCS Code: G0513
Short Description: Prolong prev svcs, first 30m
Long Description: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
HCPCS Code: G0514
Short Description: Prolong prev svcs, addl 30m
Long Description: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
HCPCS Code: G0515
Short Description: Cognitive skills development
Long Description: Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
HCPCS Code: G0516
Short Description: Insert drug del implant, >4
Long Description: Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
HCPCS Code: G0517
Short Description: Remove drug implant
Long Description: Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
HCPCS Code: G0518
Short Description: Remove w insert drug implant
Long Description: Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
HCPCS Code: G0659
Short Description: Drug test def simple all cl
Long Description: Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes
HCPCS Code: G0908
Short Description: Hgb > 12 g/dl
Long Description: Most recent hemoglobin (hgb) level > 12.0 g/dl
HCPCS Code: G0909
Short Description: Hbg not doc
Long Description: Hemoglobin level measurement not documented, reason not given
HCPCS Code: G0910
Short Description: Hgb <= 12 g/dl
Long Description: Most recent hemoglobin level <= 12.0 g/dl
HCPCS Code: G0913
Short Description: Improve visual funct
Long Description: Improvement in visual function achieved within 90 days following cataract surgery
HCPCS Code: G0914
Short Description: Survey not complete
Long Description: Patient care survey was not completed by patient
HCPCS Code: G0915
Short Description: No improve visual funct
Long Description: Improvement in visual function not achieved within 90 days following cataract surgery
HCPCS Code: G0916
Short Description: Satisfy with care
Long Description: Satisfaction with care achieved within 90 days following cataract surgery
HCPCS Code: G0917
Short Description: Satisfy survey not complete
Long Description: Patient satisfaction survey was not completed by patient
HCPCS Code: G0918
Short Description: No satisfy with care
Long Description: Satisfaction with care not achieved within 90 days following cataract surgery
HCPCS Code: G0919
Short Description: Flu immunize not avail
Long Description: Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit
HCPCS Code: G0920
Short Description: Type loc act doc
Long Description: Type, anatomic location, and activity all documented
HCPCS Code: G0921
Short Description: Doc pt reas no assess
Long Description: Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)
HCPCS Code: G0922
Short Description: Type loc act not doc
Long Description: No documentation of disease type, anatomic location, and activity, reason not given