2018 HCPCS Codes | Med Reference

Was this site helpful to you? We would very much appreciate you whitelisting us or using this link when you shop on Amazon (no impact on your order).

https://medreference.org/i/q/medreference__hcpcs-codes?s=&h=&d=&o=&_n=25

Procedure

Description

Procedure: Pt recv >=1 well-chld visit
Description: Patient received at least one well-child visit with a pcp during the performance period

G9964

Procedure: No well-chld vist recv by pt
Description: Patient did not receive at least one well-child visit with a pcp during the performance period

G9965

Procedure: Scrn, inter, report child
Description: Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report

G9966

Procedure: No scrn, inter, reprt child
Description: Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report

G9967

Procedure: Pt refrd 2 pvdr/spclst in pp
Description: Patient was referred to another provider or specialist during the performance period

G9968

Procedure: Pvdr rfrd pt rprt rcvd
Description: Provider who referred the patient to another provider received a report from the provider to whom the patient was referred

G9969

Procedure: Pvdr rfrd pt no rprt rcvd
Description: Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred

G9970

Procedure: Mac exam perf
Description: Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity

G9974

Procedure: Doc med rsn no dil mac exam
Description: Documentation of medical reason(s) for not performing a dilated macular examination

G9975

Procedure: Remote e/m new pt 10mins
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9978

Procedure: Remote e/m new pt 20mins
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9979

Procedure: Remote e/m new pt 30 mins
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9980

Procedure: Remote e/m new pt 45mins
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9981

Procedure: Remote e/m new pt 60mins
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9982

Procedure: Remote e/m est. pt 10mins
Description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9983

Procedure: Remote e/m est. pt 15mins
Description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9984

Procedure: Remote e/m est. pt 25mins
Description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9985

Procedure: Remote e/m est. pt 40mins
Description: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

G9986

Procedure: Bpci advanced in home visit
Description: Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code

G9987

Procedure: Inj, afstyla, 1 i.u.
Description: Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.

J7210

Procedure: Inj, kovaltry, 1 i.u.
Description: Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.

J7211

Procedure: Aminolevulinic acid, 10% gel
Description: Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg

J7345

Procedure: Injection, avelumab, 10 mg
Description: Injection, avelumab, 10 mg

J9023

Procedure: Inj, olaratumab, 10 mg
Description: Injection, olaratumab, 10 mg

J9285

Procedure: Tisagenlecleucel car-pos t
Description: Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion

Q2040

Procedure: Axicabtagene ciloleucel car+
Description: Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Q2041

Procedure: Neopatch, per sq centimeter
Description: Neopatch, per square centimeter

Q4176

Procedure: Floweramnioflo, 0.1 cc
Description: Floweramnioflo, 0.1 cc

Q4177

Procedure: Floweramniopatch, per sq cm
Description: Floweramniopatch, per square centimeter

Q4178

Procedure: Flowerderm, per sq cm
Description: Flowerderm, per square centimeter

Q4179

Procedure: Revita, per sq cm
Description: Revita, per square centimeter

Q4180

Procedure: Amnio wound, per square cm
Description: Amnio wound, per square centimeter

Q4181

Procedure: Transcyte, per sq centimeter
Description: Transcyte, per square centimeter

Q4182

Procedure: Buprenorph xr 100 mg or less
Description: Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg

Q9991

Procedure: Buprenorphine xr over 100 mg
Description: Injection, buprenorphine extended-release (sublocade), greater than 100 mg

Q9992

Procedure: Inj., emicizumab-kxwh 0.5 mg
Description: Injection, emicizumab-kxwh, 0.5 mg

Q9995

Procedure: Computed radiography x-ray
Description: X-ray taken using computed radiography technology/cassette-based imaging

Procedure: 340b acquired drug
Description: Drug or biological acquired with 340b drug pricing program discount

Procedure: Avg sta day/night o2 < 1 lpm
Description: Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)

Procedure: Avg day/nite o2 > 4 lpm/port
Description: Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed

Procedure: Qualified cdsm consulted
Description: Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional

Procedure: Avg sta day/night o2 > 4 lpm
Description: Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)

Procedure: Tracking 340b acquired drug
Description: Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes

Procedure: Mdpp virtual make-up session
Description: Medicare diabetes prevention program (mdpp) virtual make-up session

Procedure: Continuous/broad services
Description: Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care

Procedure: Continuous/focused services
Description: Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services

Procedure: Episodic/broad services
Description: Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital

Procedure: Episodic/focused services
Description: Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period

Procedure: Svc req by another clinician
Description: Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician