HCPCS Code: G8
Short Description: Monitored anesthesia care
Long Description: Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
HCPCS Code: G8126
Short Description: Pt treat w/antidepress12wks
Long Description: Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
HCPCS Code: G8127
Short Description: Pt not treat w/antidepres12w
Long Description: Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase
HCPCS Code: G8128
Short Description: Pt inelig for antidepres med
Long Description: Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure
HCPCS Code: G8395
Short Description: Lvef>=40% doc normal or mild
Long Description: Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
HCPCS Code: G8396
Short Description: Lvef not performed
Long Description: Left ventricular ejection fraction (lvef) not performed or documented
HCPCS Code: G8397
Short Description: Dil macula/fundus exam/w doc
Long Description: Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy
HCPCS Code: G8398
Short Description: Dil macular/fundus not perfo
Long Description: Dilated macular or fundus exam not performed
HCPCS Code: G8399
Short Description: Pt w/dxa results document
Long Description: Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed
HCPCS Code: G8400
Short Description: Pt w/dxa no results doc
Long Description: Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given
HCPCS Code: G8401
Short Description: Pt inelig osteo screen measu
Long Description: Clinician documented that patient was not an eligible candidate for screening
HCPCS Code: G8404
Short Description: Low extemity neur exam docum
Long Description: Lower extremity neurological exam performed and documented
HCPCS Code: G8405
Short Description: Low extemity neur not perfor
Long Description: Lower extremity neurological exam not performed
HCPCS Code: G8406
Short Description: Pt inelig lower extrem neuro
Long Description: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure
HCPCS Code: G8410
Short Description: Eval on foot documented
Long Description: Footwear evaluation performed and documented
HCPCS Code: G8415
Short Description: Eval on foot not performed
Long Description: Footwear evaluation was not performed
HCPCS Code: G8416
Short Description: Pt inelig footwear evaluatio
Long Description: Clinician documented that patient was not an eligible candidate for footwear evaluation measure
HCPCS Code: G8417
Short Description: Calc bmi abv up param f/u
Long Description: Bmi is documented above normal parameters and a follow-up plan is documented
HCPCS Code: G8418
Short Description: Calc bmi blw low param f/u
Long Description: Bmi is documented below normal parameters and a follow-up plan is documented
HCPCS Code: G8419
Short Description: Calc bmi out nrm param nof/u
Long Description: Bmi documented outside normal parameters, no follow-up plan documented, no reason given
HCPCS Code: G8420
Short Description: Calc bmi norm parameters
Long Description: Bmi is documented within normal parameters and no follow-up plan is required
HCPCS Code: G8421
Short Description: Bmi not calculated
Long Description: Bmi not documented and no reason is given
HCPCS Code: G8422
Short Description: Pt inelig bmi calculation
Long Description: Bmi not documented, documentation the patient is not eligible for bmi calculation
HCPCS Code: G8427
Short Description: Docrev cur meds by elig clin
Long Description: Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications
HCPCS Code: G8428
Short Description: Cur meds not document
Long Description: Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given
HCPCS Code: G8430
Short Description: Ec at doc medrec pt not elig
Long Description: Eligible clinician attests to documenting in the medical record the patient is not eligible for a current list of medications being obtained, updated, or reviewed by the eligible clinician
HCPCS Code: G8431
Short Description: Pos clin depres scrn f/u doc
Long Description: Screening for depression is documented as being positive and a follow-up plan is documented
HCPCS Code: G8432
Short Description: Dep scr not doc, rng
Long Description: Depression screening not documented, reason not given
HCPCS Code: G8433
Short Description: Scr for dep not cpt doc rsn
Long Description: Screening for depression not completed, documented reason
HCPCS Code: G8442
Short Description: Doc pain as nt perf, not elg
Long Description: Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter
HCPCS Code: G8450
Short Description: Beta-bloc rx pt w/abn lvef
Long Description: Beta-blocker therapy prescribed
HCPCS Code: G8451
Short Description: Pt w/abn lvef inelig b-bloc
Long Description: Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons, or other reasons attributable to the healthcare system)
HCPCS Code: G8452
Short Description: Pt w/abn lvef b-bloc no rx
Long Description: Beta-blocker therapy not prescribed
HCPCS Code: G8458
Short Description: Pt inelig geno no antvir tx
Long Description: Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)
HCPCS Code: G8460
Short Description: Pt inelig rna no antvir tx
Long Description: Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c
HCPCS Code: G8461
Short Description: Pt rec antivir treat hep c
Long Description: Patient receiving antiviral treatment for hepatitis c during the measurement period
HCPCS Code: G8464
Short Description: Pt inelig; lo to no dter rsk
Long Description: Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined
HCPCS Code: G8465
Short Description: High risk recurrence pro ca
Long Description: High or very high risk of recurrence of prostate cancer
HCPCS Code: G8473
Short Description: Ace/arb thxpy rx'd
Long Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed
HCPCS Code: G8474
Short Description: Ace/arb not rx'd; doc reas
Long Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) or (e.g., lack of drug availability, other reasons attributable to the health care system)
HCPCS Code: G8475
Short Description: Ace/arb thxpy not rx'd
Long Description: Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given
HCPCS Code: G8476
Short Description: Bp sys <140 and dias <90
Long Description: Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg
HCPCS Code: G8477
Short Description: Bp sys>=140 and/or dias >=90
Long Description: Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg
HCPCS Code: G8478
Short Description: Bp not performed/doc
Long Description: Blood pressure measurement not performed or documented, reason not given
HCPCS Code: G8482
Short Description: Flu immunize order/admin
Long Description: Influenza immunization administered or previously received
HCPCS Code: G8483
Short Description: Flu imm no admin doc rea
Long Description: Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
HCPCS Code: G8484
Short Description: Flu immunize no admin
Long Description: Influenza immunization was not administered, reason not given
HCPCS Code: G8485
Short Description: Report, diabetes measures
Long Description: I intend to report the diabetes mellitus (dm) measures group
HCPCS Code: G8486
Short Description: Report, prev care measures
Long Description: I intend to report the preventive care measures group
HCPCS Code: G8487
Short Description: Report ckd measures
Long Description: I intend to report the chronic kidney disease (ckd) measures group
HCPCS Code: G8489
Short Description: Cad measures grp
Long Description: I intend to report the coronary artery disease (cad) measures group
HCPCS Code: G8490
Short Description: Ra measures grp
Long Description: I intend to report the rheumatoid arthritis (ra) measures group
HCPCS Code: G8491
Short Description: Hiv/aids measures grp
Long Description: I intend to report the hiv/aids measures group
HCPCS Code: G8492
Short Description: Periop care measures grp
Long Description: I intend to report the perioperative care measures group
HCPCS Code: G8493
Short Description: Back pain measures grp
Long Description: I intend to report the back pain measures group
HCPCS Code: G8494
Short Description: Dm meas qual act perform
Long Description: All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient
HCPCS Code: G8495
Short Description: Ckd meas qual act perform
Long Description: All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient
HCPCS Code: G8496
Short Description: Prev care mg qual act perfrm
Long Description: All quality actions for the applicable measures in the preventive care measures group have been performed for this patient
HCPCS Code: G8497
Short Description: Cabg meas qual act perform
Long Description: All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient
HCPCS Code: G8498
Short Description: Cad meas qual act perform
Long Description: All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient
HCPCS Code: G8499
Short Description: Ra meas qual act perform
Long Description: All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient
HCPCS Code: G8500
Short Description: Hiv meas qual act perform
Long Description: All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient
HCPCS Code: G8501
Short Description: Perio meas qual act perform
Long Description: All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient
HCPCS Code: G8502
Short Description: Back pain mg qual act perfrm
Long Description: All quality actions for the applicable measures in the back pain measures group have been performed for this patient
HCPCS Code: G8506
Short Description: Pt rec ace/arb
Long Description: Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
HCPCS Code: G8509
Short Description: Pos pain assess no f/u doc
Long Description: Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given
HCPCS Code: G8510
Short Description: Scr dep neg, no plan reqd
Long Description: Screening for depression is documented as negative, a follow-up plan is not required
HCPCS Code: G8511
Short Description: Scr dep pos, no plan doc rng
Long Description: Screening for depression documented as positive, follow-up plan not documented, reason not given
HCPCS Code: G8530
Short Description: Auto av fistula recd
Long Description: Autogenous av fistula received
HCPCS Code: G8531
Short Description: Pt inelig; auto av fistula
Long Description: Clinician documented that patient was not an eligible candidate for autogenous av fistula
HCPCS Code: G8532
Short Description: No auto av fistula; no reas
Long Description: Clinician documented that patient received vascular access other than autogenous av fistula, reason not given
HCPCS Code: G8535
Short Description: Eld maltreatment not doc
Long Description: Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter
HCPCS Code: G8536
Short Description: No doc elder mal scrn
Long Description: No documentation of an elder maltreatment screen, reason not given
HCPCS Code: G8539
Short Description: Doc funct and care plan
Long Description: Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documented
HCPCS Code: G8540
Short Description: Foa not doc as being perf
Long Description: Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter
HCPCS Code: G8541
Short Description: No doc cur funct assess
Long Description: Functional outcome assessment using a standardized tool not documented, reason not given
HCPCS Code: G8542
Short Description: Doc funct no deficiencies
Long Description: Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required
HCPCS Code: G8543
Short Description: Cur funct asses; no care pln
Long Description: Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given
HCPCS Code: G8544
Short Description: Cabg measures grp
Long Description: I intend to report the coronary artery bypass graft (cabg) measures group
HCPCS Code: G8545
Short Description: Hepc measures grp
Long Description: I intend to report the hepatitis c measures group
HCPCS Code: G8547
Short Description: Ivd measures grp
Long Description: I intend to report the ischemic vascular disease (ivd) measures group
HCPCS Code: G8548
Short Description: Hf measures grp
Long Description: I intend to report the heart failure (hf) measures group
HCPCS Code: G8549
Short Description: Hepc mg qual act perform
Long Description: All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient
HCPCS Code: G8551
Short Description: Hf mg qual act perform
Long Description: All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient
HCPCS Code: G8552
Short Description: Ivd mg qual act perform
Long Description: All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient
HCPCS Code: G8559
Short Description: Pt ref doc oto eval
Long Description: Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
HCPCS Code: G8560
Short Description: Pt hx act drain prev 90 days
Long Description: Patient has a history of active drainage from the ear within the previous 90 days
HCPCS Code: G8561
Short Description: Pt inelig for ref oto eval
Long Description: Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
HCPCS Code: G8562
Short Description: Pt no hx act drain 90 d
Long Description: Patient does not have a history of active drainage from the ear within the previous 90 days
HCPCS Code: G8563
Short Description: Pt no ref oto reas no spec
Long Description: Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
HCPCS Code: G8564
Short Description: Pt ref oto eval
Long Description: Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)
HCPCS Code: G8565
Short Description: Ver doc hear loss
Long Description: Verification and documentation of sudden or rapidly progressive hearing loss
HCPCS Code: G8566
Short Description: Pt inelig ref oto eval
Long Description: Patient is not eligible for the referral for otologic evaluation for sudden or rapidly progressive hearing loss measure
HCPCS Code: G8567
Short Description: Pt no doc hear loss
Long Description: Patient does not have verification and documentation of sudden or rapidly progressive hearing loss
HCPCS Code: G8568
Short Description: Pt no ref otolo no spec
Long Description: Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
HCPCS Code: G8569
Short Description: Prol intubation req
Long Description: Prolonged postoperative intubation (> 24 hrs) required
HCPCS Code: G8570
Short Description: No prol intub req
Long Description: Prolonged postoperative intubation (> 24 hrs) not required
HCPCS Code: G8571
Short Description: Ster wd ifx 30 d postop
Long Description: Development of deep sternal wound infection/mediastinitis within 30 days postoperatively
HCPCS Code: G8572
Short Description: No ster wd ifx
Long Description: No deep sternal wound infection/mediastinitis
HCPCS Code: G8573
Short Description: Stk cabg
Long Description: Stroke following isolated cabg surgery
HCPCS Code: G8574
Short Description: No strk cabg
Long Description: No stroke following isolated cabg surgery
HCPCS Code: G8575
Short Description: Postop ren fail
Long Description: Developed postoperative renal failure or required dialysis
HCPCS Code: G8576
Short Description: No postop ren fail
Long Description: No postoperative renal failure/dialysis not required
HCPCS Code: G8577
Short Description: Reop req bld grft oth
Long Description: Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
HCPCS Code: G8578
Short Description: No reop req bld grft oth
Long Description: Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason
HCPCS Code: G8579
Short Description: Antplt med disch
Long Description: Antiplatelet medication at discharge
HCPCS Code: G8580
Short Description: Antplt med contraind
Long Description: Antiplatelet medication contraindicated
HCPCS Code: G8581
Short Description: No antplt med disch
Long Description: No antiplatelet medication at discharge
HCPCS Code: G8582
Short Description: Bblock disch
Long Description: Beta-blocker at discharge
HCPCS Code: G8583
Short Description: Bblock contraind
Long Description: Beta-blocker contraindicated
HCPCS Code: G8584
Short Description: No bblock disch
Long Description: No beta-blocker at discharge
HCPCS Code: G8585
Short Description: Antilipid treat disch
Long Description: Anti-lipid treatment at discharge
HCPCS Code: G8586
Short Description: Antlip disch contra
Long Description: Anti-lipid treatment contraindicated
HCPCS Code: G8587
Short Description: No antlipid treat disch
Long Description: No anti-lipid treatment at discharge
HCPCS Code: G8593
Short Description: Lipid pn results
Long Description: Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
HCPCS Code: G8594
Short Description: No lipid prof perf
Long Description: Lipid profile not performed, reason not given
HCPCS Code: G8595
Short Description: Ldl < 100
Long Description: Most recent ldl-c < 100 mg/dl
HCPCS Code: G8597
Short Description: Ldl >= 100
Long Description: Most recent ldl-c >= 100 mg/dl
HCPCS Code: G8598
Short Description: Asa/antiplat ther used
Long Description: Aspirin or another antiplatelet therapy used
HCPCS Code: G8599
Short Description: No asa/antiplat ther use rng
Long Description: Aspirin or another antiplatelet therapy not used, reason not given
HCPCS Code: G8600
Short Description: Tpa initi w/in 3 hrs
Long Description: Iv t-pa initiated within three hours (<= 180 minutes) of time last known well
HCPCS Code: G8601
Short Description: No elig tpa init w/in 3 hrs
Long Description: Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinician
HCPCS Code: G8602
Short Description: No tpa init w/in 3 hrs
Long Description: Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not given
HCPCS Code: G8627
Short Description: Surg proc w/in 30 days
Long Description: Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)
HCPCS Code: G8628
Short Description: No surg proc w/in 30 days
Long Description: Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)
HCPCS Code: G8629
Short Description: Doc antibio order b/4 surg
Long Description: Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)
HCPCS Code: G8630
Short Description: Doc antibio given b/4 surg
Long Description: Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered
HCPCS Code: G8631
Short Description: Pt no elg 4 order antbi give
Long Description: Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)
HCPCS Code: G8632
Short Description: Doc no antibi order b/4 surg
Long Description: Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given
HCPCS Code: G8633
Short Description: Pharm ther osteo rx
Long Description: Pharmacologic therapy (other than minierals/vitamins) for osteoporosis prescribed
HCPCS Code: G8634
Short Description: Pt no elg phar ther osteo
Long Description: Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
HCPCS Code: G8635
Short Description: No pharm ther osteo rx
Long Description: Pharmacologic therapy for osteoporosis was not prescribed, reason not given
HCPCS Code: G8645
Short Description: Asthma measures grp
Long Description: I intend to report the asthma measures group
HCPCS Code: G8646
Short Description: Asthma mg qual act perform
Long Description: All quality actions for the applicable measures in the asthma measures group have been performed for this patient
HCPCS Code: G8647
Short Description: Fun stat score knee >= 0
Long Description: Risk-adjusted functional status change residual score for the knee successfully calculated and the score was equal to zero (0) or greater than zero (>0)
HCPCS Code: G8648
Short Description: Fun stat score knee < 0
Long Description: Risk-adjusted functional status change residual score for the knee successfully calculated and the score was less than zero (<0)
HCPCS Code: G8649
Short Description: Rafscrs knee no msr, no foto
Long Description: Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's status survey near discharge, not appropriate
HCPCS Code: G8650
Short Description: Fun stat score knee not done
Long Description: Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8651
Short Description: Fun stat score hip >= 0
Long Description: Risk-adjusted functional status change residual score for the hip successfully calculated and the score was equal to zero (0) or greater than zero (>0)
HCPCS Code: G8652
Short Description: Fun stat score hip < 0
Long Description: Risk-adjusted functional status change residual score for the hip successfully calculated and the score was less than zero (<0)
HCPCS Code: G8653
Short Description: Rafscrs hip, no msr, no surv
Long Description: Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete follow up status survey near discharge, patient not appropriate
HCPCS Code: G8654
Short Description: Fun stat score hip not done
Long Description: Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8655
Short Description: Rafscrs ft ank score >=0
Long Description: Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)
HCPCS Code: G8656
Short Description: Rafscrs ft ank score < 0
Long Description: Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was less than zero (< 0)
HCPCS Code: G8657
Short Description: Rafscrs foot, no msr/no foto
Long Description: Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
HCPCS Code: G8658
Short Description: Rafscrs foot, no msr/no surv
Long Description: Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8659
Short Description: Rafscrs lumb score >= 0
Long Description: Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
HCPCS Code: G8660
Short Description: Rafscrs lumb score < 0
Long Description: Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was less than zero (< 0)
HCPCS Code: G8661
Short Description: Rafscrs lum, no msr/no foto
Long Description: Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
HCPCS Code: G8662
Short Description: Rafscrs lum, no msr/no surv
Long Description: Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8663
Short Description: Fun stat score shdl >=0
Long Description: Risk-adjusted functional status change residual score for the shoulder successfully calculated and the score was equal to zero (0) or greater than zero (>0)
HCPCS Code: G8664
Short Description: Fun stat score shdl < 0
Long Description: Risk-adjusted functional status change residual score for the shoulder successfully calculated and the score was less than zero (<0)
HCPCS Code: G8665
Short Description: Rafscrs shldr, no msr/foto
Long Description: Risk-adjusted functional status change residual scores for the shoulder not measured because the patient did not complete foto's functional status survey near discharge, patient not appropriate
HCPCS Code: G8666
Short Description: Fun stat score shdl not done
Long Description: Risk-adjusted functional status change residual scores for the shoulder not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8667
Short Description: Fun stat score ue >=0
Long Description: Risk-adjusted functional status change residual score for the elbow, wrist or hand successfully calculated and the score was equal to zero (0) or greater than zero (>0)
HCPCS Code: G8668
Short Description: Fun stat score ue < 0
Long Description: Risk-adjusted functional status change residual score for the elbow, wrist or hand successfully calculated and the score was less than zero (<0)
HCPCS Code: G8669
Short Description: Rafscrs hand, no msr/surv
Long Description: Risk-adjusted functional status change residual scores for the elbow, wrist or hand not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
HCPCS Code: G8670
Short Description: Fun stat score ue not done
Long Description: Risk-adjusted functional status change residual scores for the elbow, wrist or hand not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8671
Short Description: Rafscrs neck, score >/=0
Long Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
HCPCS Code: G8672
Short Description: Rafscrs neck, score <0
Long Description: Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was less than zero (< 0)
HCPCS Code: G8673
Short Description: Rafscrs neck, no msr/no foto
Long Description: Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
HCPCS Code: G8674
Short Description: Rafscrs neck, no msr/no foto
Long Description: Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
HCPCS Code: G8682
Short Description: Lvg test perf
Long Description: Lvf testing documented as being performed prior to discharge or in the previous 12 months
HCPCS Code: G8683
Short Description: Pt not elig for lvf test
Long Description: Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason
HCPCS Code: G8685
Short Description: Lvf test not perf
Long Description: Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given
HCPCS Code: G8694
Short Description: Lvef <40%
Long Description: Left ventricular ejection fraction (lvef) < 40%
HCPCS Code: G8696
Short Description: Antithromb thx presc
Long Description: Antithrombotic therapy prescribed at discharge
HCPCS Code: G8697
Short Description: Antithromb no presc doc reas
Long Description: Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))
HCPCS Code: G8698
Short Description: Antithromb no presc no reas
Long Description: Antithrombotic therapy was not prescribed at discharge, reason not given
HCPCS Code: G8699
Short Description: Rehab ordered disch
Long Description: Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge
HCPCS Code: G8700
Short Description: Rehab not indicated disch
Long Description: Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
HCPCS Code: G8701
Short Description: Rehab not ordered
Long Description: Rehabilitation services were not ordered, reason not otherwise specified
HCPCS Code: G8702
Short Description: Antiobiotics 4 hr prior surg
Long Description: Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
HCPCS Code: G8703
Short Description: Antibiotics not prior surg
Long Description: Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
HCPCS Code: G8704
Short Description: Ecg performed
Long Description: 12-lead electrocardiogram (ecg) performed
HCPCS Code: G8705
Short Description: Med reas no ecg
Long Description: Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)
HCPCS Code: G8706
Short Description: Pt reas no ecg
Long Description: Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)
HCPCS Code: G8707
Short Description: Ecg not performed
Long Description: 12-lead electrocardiogram (ecg) not performed, reason not given
HCPCS Code: G8708
Short Description: Antibiotic not pres
Long Description: Patient not prescribed or dispensed antibiotic
HCPCS Code: G8709
Short Description: Med reas antibiotic pres
Long Description: Patient prescribed or dispensed antibiotic for documented medical reason(s) (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases (female reproductive organs)), infections of the kidney, cystitis or uti, and acne)
HCPCS Code: G8710
Short Description: Pt pres antibiotic
Long Description: Patient prescribed or dispensed antibiotic
HCPCS Code: G8711
Short Description: Pres antibiotic
Long Description: Prescribed or dispensed antibiotic
HCPCS Code: G8712
Short Description: Not pres antibiotic
Long Description: Antibiotic not prescribed or dispensed
HCPCS Code: G8713
Short Description: Spkt/v great 1.2 kt/v
Long Description: Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])
HCPCS Code: G8714
Short Description: Hemodialysis 3 times week
Long Description: Hemodialysis treatment performed exactly three times per week for > 90 days
HCPCS Code: G8717
Short Description: Less 1.2 kt/v
Long Description: Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given
HCPCS Code: G8718
Short Description: Great 1.7 kt/v per week
Long Description: Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])
HCPCS Code: G8720
Short Description: Less 1.7 kt/v per week
Long Description: Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])
HCPCS Code: G8721
Short Description: Pt, pn, hist grade doc
Long Description: Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
HCPCS Code: G8722
Short Description: Med reas pt, pn, not doc
Long Description: Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)
HCPCS Code: G8723
Short Description: Spec sit not prim tumor
Long Description: Specimen site is other than anatomic location of primary tumor
HCPCS Code: G8724
Short Description: Pt, pn, hist grade not doc
Long Description: Pt category, pn category and histologic grade were not documented in the pathology report, reason not given
HCPCS Code: G8725
Short Description: Lipid profile perf doc
Long Description: Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)
HCPCS Code: G8726
Short Description: Doc reas no lipid profile
Long Description: Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
HCPCS Code: G8728
Short Description: Lipid profile not perf
Long Description: Fasting lipid profile not performed, reason not given
HCPCS Code: G8730
Short Description: Pain doc pos and plan
Long Description: Pain assessment documented as positive using a standardized tool and a follow-up plan is documented
HCPCS Code: G8731
Short Description: Pain neg no plan
Long Description: Pain assessment using a standardized tool is documented as negative, no follow-up plan required
HCPCS Code: G8732
Short Description: No doc of pain
Long Description: No documentation of pain assessment, reason not given
HCPCS Code: G8733
Short Description: Doc pos elder mal scrn plan
Long Description: Elder maltreatment screen documented as positive and a follow-up plan is documented
HCPCS Code: G8734
Short Description: Doc neg elder mal no plan
Long Description: Elder maltreatment screen documented as negative, no follow-up required
HCPCS Code: G8735
Short Description: Eld mal scrn pos no plan
Long Description: Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given
HCPCS Code: G8736
Short Description: Ldl-c <100mg/dl
Long Description: Most current ldl-c <100mg/dl
HCPCS Code: G8737
Short Description: Ldl-c >=100mg/dl
Long Description: Most current ldl-c >=100mg/dl
HCPCS Code: G8738
Short Description: Lvef < 40%
Long Description: Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function
HCPCS Code: G8739
Short Description: Lvef >= 40%
Long Description: Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
HCPCS Code: G8740
Short Description: Lvef not perfrmd
Long Description: Left ventricular ejection fraction (lvef) not performed or assessed, reason not given
HCPCS Code: G8749
Short Description: Signs of melanoma absent
Long Description: Absence of signs of melanoma (cough, dyspnea, tenderness, localized neurologic signs such as weakness, jaundice or any other sign suggesting systemic spread) or absence of symptoms of melanoma (pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma)
HCPCS Code: G8751
Short Description: Smkg status not assess
Long Description: Smoking status and exposure to second hand smoke in the home not assessed, reason not given
HCPCS Code: G8752
Short Description: Sys bp less 140
Long Description: Most recent systolic blood pressure < 140 mmhg
HCPCS Code: G8753
Short Description: Sys bp > or = 140
Long Description: Most recent systolic blood pressure >= 140 mmhg
HCPCS Code: G8754
Short Description: Dias bp less 90
Long Description: Most recent diastolic blood pressure < 90 mmhg
HCPCS Code: G8755
Short Description: Dias bp > or = 90
Long Description: Most recent diastolic blood pressure >= 90 mmhg
HCPCS Code: G8756
Short Description: No bp measure doc
Long Description: No documentation of blood pressure measurement, reason not given
HCPCS Code: G8757
Short Description: Copd mg qual act perform
Long Description: All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient
HCPCS Code: G8758
Short Description: Ibd mg qual act perform
Long Description: All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient
HCPCS Code: G8759
Short Description: Osa mg qual act perform
Long Description: All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient
HCPCS Code: G8761
Short Description: Dementia mg qual act perform
Long Description: All quality actions for the applicable measures in the dementia measures group have been performed for this patient
HCPCS Code: G8762
Short Description: Pd mg qual act perform
Long Description: All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient
HCPCS Code: G8763
Short Description: Hyperten mg qual act perform
Long Description: All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient
HCPCS Code: G8764
Short Description: Car prev mg qual act perform
Long Description: All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient
HCPCS Code: G8765
Short Description: Cataract mg qual act perform
Long Description: All quality actions for the applicable measures in the cataract measures group have been performed for this patient
HCPCS Code: G8767
Short Description: Lipid panel res doc rev
Long Description: Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)
HCPCS Code: G8768
Short Description: Doc med reas no lipid profle
Long Description: Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8769
Short Description: Lipid profile not perform
Long Description: Lipid profile not performed, reason not given
HCPCS Code: G8770
Short Description: Urine protein test doc rev
Long Description: Urine protein test result documented and reviewed
HCPCS Code: G8771
Short Description: Doc dx ckd
Long Description: Documentation of diagnosis of chronic kidney disease
HCPCS Code: G8772
Short Description: Doc med reas no urine protn
Long Description: Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)
HCPCS Code: G8773
Short Description: No urine protein test
Long Description: Urine protein test was not performed, reason not given
HCPCS Code: G8774
Short Description: Serum creatinine doc rev
Long Description: Serum creatinine test result documented and reviewed
HCPCS Code: G8775
Short Description: Doc med reas no serum crtn
Long Description: Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8776
Short Description: No serum creatinine test
Long Description: Serum creatinine test not performed, reason not given
HCPCS Code: G8777
Short Description: Diabetes screen
Long Description: Diabetes screening test performed
HCPCS Code: G8778
Short Description: Doc med reas no diabete scrn
Long Description: Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8779
Short Description: No diabetes screen
Long Description: Diabetes screening test not performed, reason not given
HCPCS Code: G8780
Short Description: Counsel diet phys activity
Long Description: Counseling for diet and physical activity performed
HCPCS Code: G8781
Short Description: Doc med reas no counsel diet
Long Description: Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8782
Short Description: No counsel diet phys act
Long Description: Counseling for diet and physical activity not performed, reason not given
HCPCS Code: G8783
Short Description: Bp scrn perf rec interval
Long Description: Normal blood pressure reading documented, follow-up not required
HCPCS Code: G8784
Short Description: Pt no elig for bp assess
Long Description: Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)
HCPCS Code: G8785
Short Description: Bp scrn no perf at interval
Long Description: Blood pressure reading not documented, reason not given
HCPCS Code: G8797
Short Description: Specimen site not esophagus
Long Description: Specimen site other than anatomic location of esophagus
HCPCS Code: G8798
Short Description: Specimen site not prostate
Long Description: Specimen site other than anatomic location of prostate
HCPCS Code: G8806
Short Description: Transab or transvag us
Long Description: Performance of trans-abdominal or trans-vaginal ultrasound
HCPCS Code: G8807
Short Description: Doc reas no us
Long Description: Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ed multiple times within 72 hours, patient has a documented intrauterine pregnancy [iup])
HCPCS Code: G8808
Short Description: Ultrasound not perf, rng
Long Description: Trans-abdominal or trans-vaginal ultrasound not performed, reason not given
HCPCS Code: G8809
Short Description: Rh-immunoglobulin order
Long Description: Rh-immunoglobulin (rhogam) ordered
HCPCS Code: G8810
Short Description: Doc reas no rh-immuno
Long Description: Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)
HCPCS Code: G8811
Short Description: No rh-immunoglobulin order
Long Description: Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
HCPCS Code: G8815
Short Description: Doc reas no statin therapy
Long Description: Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
HCPCS Code: G8816
Short Description: Statin med pres at disch
Long Description: Statin medication prescribed at discharge
HCPCS Code: G8817
Short Description: Doc reas no statin med disch
Long Description: Statin therapy not prescribed at discharge, reason not given
HCPCS Code: G8818
Short Description: Pt disch to home by day#7
Long Description: Patient discharge to home no later than post-operative day #7
HCPCS Code: G8825
Short Description: Pt not disch to home day#7
Long Description: Patient not discharged to home by post-operative day #7
HCPCS Code: G8826
Short Description: Pt disch home day #2 evar
Long Description: Patient discharge to home no later than post-operative day #2 following evar
HCPCS Code: G8833
Short Description: Pt not disch home day#2 evar
Long Description: Patient not discharged to home by post-operative day #2 following evar
HCPCS Code: G8834
Short Description: Pt disch home day #2 cea
Long Description: Patient discharged to home no later than post-operative day #2 following cea
HCPCS Code: G8838
Short Description: Not disch home by day #2
Long Description: Patient not discharged to home by post-operative day #2 following cea
HCPCS Code: G8839
Short Description: Sleep apnea assess
Long Description: Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness
HCPCS Code: G8840
Short Description: Doc reas no sleep apnea
Long Description: Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)
HCPCS Code: G8841
Short Description: No sleep apnea assess
Long Description: Sleep apnea symptoms not assessed, reason not given
HCPCS Code: G8842
Short Description: Ahi or rdi initial dx
Long Description: Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosis
HCPCS Code: G8843
Short Description: Doc reas no ahi or rdi
Long Description: Documentation of reason(s) for not measuring an apnea hypopnea index (ahi) or a respiratory disturbance index (rdi) at the time of initial diagnosis (e.g., psychiatric disease, dementia, patient declined, financial, insurance coverage, test ordered but not yet completed)
HCPCS Code: G8844
Short Description: No ahi or rdi initial dx
Long Description: Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) not measured at the time of initial diagnosis, reason not given
HCPCS Code: G8845
Short Description: Pos airway press prescribed
Long Description: Positive airway pressure therapy prescribed
HCPCS Code: G8846
Short Description: Mod or severe osa
Long Description: Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)
HCPCS Code: G8848
Short Description: Mild osa
Long Description: Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)
HCPCS Code: G8849
Short Description: Doc reas no pos air press
Long Description: Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)
HCPCS Code: G8850
Short Description: No pap prescribed
Long Description: Positive airway pressure therapy not prescribed, reason not given
HCPCS Code: G8851
Short Description: Adhere pos air press therapy
Long Description: Objective measurement of adherence to positive airway pressure therapy, documented
HCPCS Code: G8852
Short Description: Pos air press prescribe
Long Description: Positive airway pressure therapy prescribed
HCPCS Code: G8853
Short Description: Pos air press not prescribe
Long Description: Positive airway pressure therapy not prescribed
HCPCS Code: G8854
Short Description: Reas no adhere pos air pres
Long Description: Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn't bring data from continous positive airway pressure [cpap], therapy not yet initiated, not available on machine)
HCPCS Code: G8855
Short Description: Pos air press adhere no perf
Long Description: Objective measurement of adherence to positive airway pressure therapy not performed, reason not given
HCPCS Code: G8856
Short Description: Ref for oto eval
Long Description: Referral to a physician for an otologic evaluation performed
HCPCS Code: G8857
Short Description: No elig ref for oto eval
Long Description: Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)
HCPCS Code: G8858
Short Description: Not ref for oto eval
Long Description: Referral to a physician for an otologic evaluation not performed, reason not given
HCPCS Code: G8859
Short Description: Corticosteroids 10mg 60 days
Long Description: Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
HCPCS Code: G8860
Short Description: Corticosteroid 10 mg 60 days
Long Description: Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
HCPCS Code: G8861
Short Description: Dxa ordered for osteo
Long Description: Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed
HCPCS Code: G8862
Short Description: No corticostrd 10mg 60 days
Long Description: Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days
HCPCS Code: G8863
Short Description: No assess bone loss
Long Description: Patients not assessed for risk of bone loss, reason not given
HCPCS Code: G8864
Short Description: Pneumococcal vaccine admin
Long Description: Pneumococcal vaccine administered or previously received
HCPCS Code: G8865
Short Description: Doc med reas no pneumococcal
Long Description: Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
HCPCS Code: G8866
Short Description: Doc pt reas no pneumococcal
Long Description: Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)
HCPCS Code: G8867
Short Description: No pneumococcal admin
Long Description: Pneumococcal vaccine not administered or previously received, reason not given
HCPCS Code: G8868
Short Description: 1st course antitnf
Long Description: Patients receiving a first course of anti-tnf therapy
HCPCS Code: G8869
Short Description: Doc immune hep b antitnf
Long Description: Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
HCPCS Code: G8870
Short Description: Hepb admin 1st antitnf
Long Description: Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy
HCPCS Code: G8871
Short Description: No 1st antitnf
Long Description: Patient not receiving a first course of anti-tnf therapy
HCPCS Code: G8872
Short Description: Intraop image confirm excise
Long Description: Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
HCPCS Code: G8873
Short Description: Specimen not intraop image
Long Description: Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
HCPCS Code: G8874
Short Description: Tissue not image intraop
Long Description: Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
HCPCS Code: G8875
Short Description: Breast cancer dx min invsive
Long Description: Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
HCPCS Code: G8876
Short Description: Doc reas no min inv dx
Long Description: Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)
HCPCS Code: G8877
Short Description: No brst cncr dx min invasive
Long Description: Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given
HCPCS Code: G8878
Short Description: Sent lymph node biopsy
Long Description: Sentinel lymph node biopsy procedure performed
HCPCS Code: G8879
Short Description: Node neg inv brst cncr
Long Description: Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
HCPCS Code: G8880
Short Description: Sen lym p node biop not perf
Long Description: Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent)
HCPCS Code: G8881
Short Description: Brst cncr stage > t1n0m0
Long Description: Stage of breast cancer is greater than t1n0m0 or t2n0m0
HCPCS Code: G8882
Short Description: No sent lymph node biopsy
Long Description: Sentinel lymph node biopsy procedure not performed, reason not given
HCPCS Code: G8883
Short Description: Rev, comm, track, doc biopsy
Long Description: Biopsy results reviewed, communicated, tracked and documented
HCPCS Code: G8884
Short Description: Doc reas biopsy not review
Long Description: Clinician documented reason that patient's biopsy results were not reviewed
HCPCS Code: G8885
Short Description: No rev, comm, track biopsy
Long Description: Biopsy results not reviewed, communicated, tracked or documented
HCPCS Code: G8886
Short Description: Bp under control
Long Description: Most recent blood pressure under control
HCPCS Code: G8887
Short Description: Doc med reas bp not control
Long Description: Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8888
Short Description: Bp not under control
Long Description: Most recent blood pressure not under control, results documented and reviewed
HCPCS Code: G8889
Short Description: No doc bp
Long Description: No documentation of blood pressure measurement, reason not given
HCPCS Code: G8890
Short Description: Ldl-c under control
Long Description: Most recent ldl-c under control, results documented and reviewed
HCPCS Code: G8891
Short Description: Doc med reas no ldl-c contrl
Long Description: Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8892
Short Description: Doc med reas no ldl-c test
Long Description: Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)
HCPCS Code: G8893
Short Description: Ldl-c not under control
Long Description: Most recent ldl-c not under control, results documented and reviewed
HCPCS Code: G8894
Short Description: Ldl-c not performed
Long Description: Ldl-c not performed, reason not given
HCPCS Code: G8895
Short Description: Antrom prescribe
Long Description: Oral aspirin or other antithrombotic therapy prescribed
HCPCS Code: G8896
Short Description: Doc med reas no antihtrom
Long Description: Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)
HCPCS Code: G8897
Short Description: Antithrom not prescribe
Long Description: Oral aspirin or other antithrombotic therapy was not prescribed, reason not given
HCPCS Code: G8898
Short Description: Copd measures group
Long Description: I intend to report the chronic obstructive pulmonary disease (copd) measures group
HCPCS Code: G8899
Short Description: Inflammatory bowel dis mg
Long Description: I intend to report the inflammatory bowel disease (ibd) measures group
HCPCS Code: G8900
Short Description: Obstructive sleep apnea mg
Long Description: I intend to report the sleep apnea measures group
HCPCS Code: G8902
Short Description: Dementia measures group
Long Description: I intend to report the dementia measures group
HCPCS Code: G8903
Short Description: Parkinson's disease mg
Long Description: I intend to report the parkinson's disease measures group
HCPCS Code: G8904
Short Description: Hypertension mg
Long Description: I intend to report the hypertension (htn) measures group
HCPCS Code: G8905
Short Description: Cardiovascular prevention mg
Long Description: I intend to report the cardiovascular prevention measures group
HCPCS Code: G8906
Short Description: Cataract measures group
Long Description: I intend to report the cataract measures group
HCPCS Code: G8907
Short Description: Pt doc no events on discharg
Long Description: Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility
HCPCS Code: G8908
Short Description: Pt doc w burn prior to d/c
Long Description: Patient documented to have received a burn prior to discharge
HCPCS Code: G8909
Short Description: Pt doc no burn prior to d/c
Long Description: Patient documented not to have received a burn prior to discharge
HCPCS Code: G8910
Short Description: Pt doc to have fall in asc
Long Description: Patient documented to have experienced a fall within asc
HCPCS Code: G8911
Short Description: Pt doc no fall in asc
Long Description: Patient documented not to have experienced a fall within ambulatory surgical center
HCPCS Code: G8912
Short Description: Pt doc with wrong event
Long Description: Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
HCPCS Code: G8913
Short Description: Pt doc no wrong event
Long Description: Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
HCPCS Code: G8914
Short Description: Pt trans to hosp post d/c
Long Description: Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc
HCPCS Code: G8915
Short Description: Pt not trans to hosp at d/c
Long Description: Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc
HCPCS Code: G8916
Short Description: Pt w iv ab given on time
Long Description: Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time
HCPCS Code: G8917
Short Description: Pt w iv ab not given on time
Long Description: Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time
HCPCS Code: G8918
Short Description: Pt w/o preop order iv ab pro
Long Description: Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis
HCPCS Code: G8923
Short Description: Lvef < 40% or lvsd
Long Description: Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function
HCPCS Code: G8924
Short Description: Spir fev1/fvc<70%,fev<60%
Long Description: Spirometry test results demonstrate fev1/fvc < 70%, fev < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
HCPCS Code: G8925
Short Description: Spir fev1/fvc>=60% & no copd
Long Description: Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms
HCPCS Code: G8926
Short Description: Spiro no perf or doc
Long Description: Spirometry test not performed or documented, reason not given
HCPCS Code: G8927
Short Description: Adj chem pres ajcc iii
Long Description: Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer
HCPCS Code: G8928
Short Description: Adj chem not pres rsn spec
Long Description: Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
HCPCS Code: G8929
Short Description: Adj cmo not pres rsn not gvn
Long Description: Adjuvant chemotherapy not prescribed or previously received, reason not given
HCPCS Code: G8930
Short Description: Assess of dep @ initial eval
Long Description: Assessment of depression severity at the initial evaluation
HCPCS Code: G8931
Short Description: Asses of dep not documented
Long Description: Assessment of depression severity not documented, reason not given
HCPCS Code: G8932
Short Description: Suicd rsk assessed init eval
Long Description: Suicide risk assessed at the initial evaluation
HCPCS Code: G8933
Short Description: Suicide risk not assessed
Long Description: Suicide risk not assessed at the initial evaluation, reason not given
HCPCS Code: G8934
Short Description: Lvef <40% or dep lv sys fcn
Long Description: Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function
HCPCS Code: G8935
Short Description: Rx ace or arb therapy
Long Description: Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
HCPCS Code: G8936
Short Description: Pt not eligible ace/arb
Long Description: Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons) or (eg, lack of drug availability, other reasons attributable to the health care system)
HCPCS Code: G8937
Short Description: No rx ace/arb therapy
Long Description: Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given
HCPCS Code: G8938
Short Description: Bmi doc onl fup nt doc
Long Description: Bmi is documented as being outside of normal limits, follow-up plan is not documented, documentation the patient is not eligible
HCPCS Code: G8939
Short Description: Pain as doc positive, no f/u
Long Description: Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter
HCPCS Code: G8940
Short Description: Scr dep pos, no plan done
Long Description: Screening for depression documented as positive, a follow-up plan not completed, documented reason
HCPCS Code: G8941
Short Description: Eld maltreatment doc as pos
Long Description: Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter
HCPCS Code: G8942
Short Description: Doc fcn/care plan w/30 days
Long Description: Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented
HCPCS Code: G8943
Short Description: Ldlc not pres w/i 12 mo prir
Long Description: Ldl-c result not present or not within 12 months prior
HCPCS Code: G8944
Short Description: Ajcc mel cnr stg 0 - iic
Long Description: Ajcc melanoma cancer stage 0 through iic melanoma
HCPCS Code: G8946
Short Description: Mibm but no dx of breast ca
Long Description: Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)
HCPCS Code: G8947
Short Description: 1 or more neuropsych
Long Description: One or more neuropsychiatric symptoms
HCPCS Code: G8948
Short Description: No neuropsych symptoms
Long Description: No neuropsychiatric symptoms
HCPCS Code: G8949
Short Description: Doc pt reas on counsel diet
Long Description: Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)
HCPCS Code: G8950
Short Description: Pre-htn or htn doc, f/u indc
Long Description: Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented
HCPCS Code: G8951
Short Description: Pre-htn/htn doc, no pt f/u
Long Description: Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible
HCPCS Code: G8952
Short Description: Pre-htn/htn, no f/u, not gvn
Long Description: Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
HCPCS Code: G8953
Short Description: Oncology mg qual act perform
Long Description: All quality actions for the applicable measures in the oncology measures group have been performed for this patient
HCPCS Code: G8955
Short Description: Most recent assess vol mgmt
Long Description: Most recent assessment of adequacy of volume management documented
HCPCS Code: G8956
Short Description: Pt rcv hedia outpt dyls fac
Long Description: Patient receiving maintenance hemodialysis in an outpatient dialysis facility
HCPCS Code: G8957
Short Description: Pt no hedia in outpt fac
Long Description: Patient not receiving maintenance hemodialysis in an outpatient dialysis facility
HCPCS Code: G8958
Short Description: Assess vol mgmt not doc
Long Description: Assessment of adequacy of volume management not documented, reason not given
HCPCS Code: G8959
Short Description: Clin tx mdd comm to tx clin
Long Description: Clinician treating major depressive disorder communicates to clinician treating comorbid condition
HCPCS Code: G8960
Short Description: Clin tx mdd not comm
Long Description: Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given
HCPCS Code: G8961
Short Description: Csit lowrisk surg pts preop
Long Description: Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery
HCPCS Code: G8962
Short Description: Csit on pt any reas 30 days
Long Description: Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery
HCPCS Code: G8963
Short Description: Csi per asx pt w/pci 2 yrs
Long Description: Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years
HCPCS Code: G8964
Short Description: Csi any other than pci 2 yr
Long Description: Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)
HCPCS Code: G8965
Short Description: Csit perf on low chd rsk
Long Description: Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment
HCPCS Code: G8966
Short Description: Csit perf sx or high chd rsk
Long Description: Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment
HCPCS Code: G8967
Short Description: Warf or other fda drug presc
Long Description: Warfarin or another fda approved oral anticoagulant is prescribed
HCPCS Code: G8968
Short Description: Doc med not presb
Long Description: Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)
HCPCS Code: G8969
Short Description: Doc pt rsn no presc warf/fda
Long Description: Documentation of patient reason(s) for not prescribing warfarin or another fda-approved oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)
HCPCS Code: G8970
Short Description: No rsk fac or 1 mod risk te
Long Description: No risk factors or one moderate risk factor for thromboembolism
HCPCS Code: G8971
Short Description: Warfrn or othr antcog no rx
Long Description: Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
HCPCS Code: G8972
Short Description: 1>=risk or>= mod risk for te
Long Description: One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
HCPCS Code: G8973
Short Description: Mst rcnt hbb < 10g/dl
Long Description: Most recent hemoglobin (hgb) level < 10 g/dl
HCPCS Code: G8974
Short Description: Hgb not doc rns not gvn
Long Description: Hemoglobin level measurement not documented, reason not given
HCPCS Code: G8975
Short Description: Hgb <10g/dl, med rsn
Long Description: Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)
HCPCS Code: G8976
Short Description: Hgb >= 10 g/dl
Long Description: Most recent hemoglobin (hgb) level >= 10 g/dl
HCPCS Code: G8977
Short Description: Oncology measures grp
Long Description: I intend to report the oncology measures group
HCPCS Code: G8978
Short Description: Mobility current status
Long Description: Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8979
Short Description: Mobility goal status
Long Description: Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8980
Short Description: Mobility d/c status
Long Description: Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8981
Short Description: Body pos current status
Long Description: Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8982
Short Description: Body pos goal status
Long Description: Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8983
Short Description: Body pos d/c status
Long Description: Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8984
Short Description: Carry current status
Long Description: Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8985
Short Description: Carry goal status
Long Description: Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8986
Short Description: Carry d/c status
Long Description: Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8987
Short Description: Self care current status
Long Description: Self care functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8988
Short Description: Self care goal status
Long Description: Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8989
Short Description: Self care d/c status
Long Description: Self care functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8990
Short Description: Other pt/ot current status
Long Description: Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8991
Short Description: Other pt/ot goal status
Long Description: Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8992
Short Description: Other pt/ot d/c status
Long Description: Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8993
Short Description: Sub pt/ot current status
Long Description: Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
HCPCS Code: G8994
Short Description: Sub pt/ot goal status
Long Description: Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8995
Short Description: Sub pt/ot d/c status
Long Description: Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8996
Short Description: Swallow current status
Long Description: Swallowing functional limitation, current status at therapy episode outset and at reporting intervals
HCPCS Code: G8997
Short Description: Swallow goal status
Long Description: Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
HCPCS Code: G8998
Short Description: Swallow d/c status
Long Description: Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting
HCPCS Code: G8999
Short Description: Motor speech current status
Long Description: Motor speech functional limitation, current status at therapy episode outset and at reporting intervals