2016 HCPCS Codes | Med Reference

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Procedure

Description

Procedure: Pt trans from anest to pacu
Description: Patient transferred directly from anesthetizing location to pacu or other non-icu location

G9656

Procedure: Toc dur aneth to icu
Description: Transfer of care during an anesthetic or to the intensive care unit

G9657

Procedure: Toc tool incl elem not used
Description: A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used

G9658

Procedure: >85y no hx colo ca/rsn scope
Description: Patients greater than 85 years of age who did not have a history of colorectal cancer or valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits

G9659

Procedure: Doc med rsn scope pt >85y
Description: Documentation of medical reason(s) for a colonoscopy performed on a patient greater than 85 years of age (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits)

G9660

Procedure: >85y scope othr rsn
Description: Patients greater than 85 years of age who received a routine colonoscopy for a reason other than the following: an assessment of signs/symptoms of gi tract illness, and/or the patient is considered high risk, and/or to follow-up on previously diagnosed advance lesions

G9661

Procedure: Prior dx/active clin ascvd
Description: Previously diagnosed or have an active diagnosis of clinical ascvd

G9662

Procedure: Fast/dir ldl = 190 mg/dl
Description: Any fasting or direct ldl-c laboratory test result = 190 mg/dl

G9663

Procedure: Taking statin or rec'd order
Description: Patients who are currently statin therapy users or received an order (prescription) for statin therapy

G9664

Procedure: No statin/no order statin
Description: Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy

G9665

Procedure: Fas/dir ldl 70-189mg/dl mst
Description: The highest fasting or direct ldl-c laboratory test result of 70-189 mg/dl in the measurement period or two years prior to the beginning of the measurement period

G9666

Procedure: Doc med rsn no stat tx/presc
Description: Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)

G9667

Procedure: Intend rpt mult chr msr grp
Description: I intend to report the multiple chronic conditions measures group

G9669

Procedure: Qty act mcc mg perf
Description: All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient

G9670

Procedure: Intend rpt dia retin msr grp
Description: I intend to report the diabetic retinopathy measures group

G9671

Procedure: Qty act diab retin mg perf
Description: All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient

G9672

Procedure: Intend rpt card prev msr grp
Description: I intend to report the cardiovascular prevention measures group

G9673

Procedure: Pt w/clin ascvd dx
Description: Patients with clinical ascvd diagnosis

G9674

Procedure: Pt w/fast/dir lab ldl-c >190
Description: Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl

G9675

Procedure: 40-75y w/type 1/2 w/ldl-c rs
Description: Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70?189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period

G9676

Procedure: Qty act card prev mg perf
Description: All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient

G9677

Procedure: Oncology care model service
Description: Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement

G9678

Procedure: Acute care pneumonia
Description: This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary

G9679

Procedure: Acute care congestive heart
Description: This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary

G9680

Procedure: Acute care chronic obstruct
Description: This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary

G9681

Procedure: Acute care skin infection
Description: This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary

G9682

Procedure: Acute fluid/electro disorder
Description: Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project

G9683

Procedure: Acute care urinary tract inf
Description: This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary

G9684

Procedure: Acute nursing facility care
Description: Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project

G9685

Procedure: Nursing facility conference
Description: Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team

G9686

Procedure: Injection, ruconest
Description: Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units

J0596

Procedure: Injection, isavuconazonium
Description: Injection, isavuconazonium, 1 mg

J1833

Procedure: Inj, pasireotide long acting
Description: Injection, pasireotide long acting, 1 mg

J2502

Procedure: Factor viii recomb obizur
Description: Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.

J7188

Procedure: Fluocinol acet intravit imp
Description: Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg

J7313

Procedure: Gelsyn-3 injection 0.1 mg
Description: Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg

J7328

Procedure: Compounded drug, noc
Description: Compounded drug, not otherwise classified

J7999

Procedure: Oral netupitant, palonosetro
Description: Netupitant 300 mg and palonosetron 0.5 mg, oral

J8655

Procedure: Bio-connekt per square cm
Description: Bio-connekt wound matrix, per square centimeter

Q4161

Procedure: Wndex flw, bioskn flw, 0.5cc
Description: Woundex flow, bioskin flow, 0.5 cc

Q4162

Procedure: Woundex, bioskin, per sq cm
Description: Woundex, bioskin, per square centimeter

Q4163

Procedure: Helicoll, per square cm
Description: Helicoll, per square centimeter

Q4164

Procedure: Keramatrix, per square cm
Description: Keramatrix, per square centimeter

Q4165

Procedure: Genvisc, inj, 1mg
Description: Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg

Q9980

Procedure: Rolapitant, oral, 1mg
Description: Rolapitant, oral, 1 mg

Q9981

Procedure: C-apc adjunctive service
Description: Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim

Procedure: Ct does not meet nema standa
Description: Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard

Procedure: Novartis/sandoz
Description: Novartis/sandoz

Procedure: Pfizer/hospira
Description: Pfizer/hospira