| New |
| Code |
Description |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed;ßsingle major coronary artery or branch |
| C9601 |
Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed;ß each additional branch of a major coronary artery (list separately in addition to code for primary procedure) |
| C9602 |
Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed;ßsingle major coronary artery or branch |
| C9603 |
Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed;ßeach additional branch of a major coronary artery (list separately in addition to code for primary procedure) |
| C9604 |
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed;ßsingle vessel |
| C9605 |
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed;ß each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure) |
| C9606 |
Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel |
| C9607 |
Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty;ßsingle vessel |
| C9608 |
Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty;ß each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure) |
| G8919 |
Most recent systolic blood pressure < 140 mmhg |
| G8920 |
Most recent systolic blood pressure >= 140 mmhg |
| G8921 |
Most recent diastolic blood pressure < 90 mmhg |
| G8922 |
Most recent diastolic blood pressure >= 90 mmhg |
| G8923 |
Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function |
| G8934 |
Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function |
| G8935 |
Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
| G8936 |
Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
| G8937 |
Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given |
| G8938 |
Bmi is calculated, but patient not eligible for follow-up plan |
| G8943 |
Ldl-c result not present or not within 12 months prior |
| G8945 |
Aneurysm minor diameter <= 6 cm for men |
| G8950 |
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up documented |
| G8951 |
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, patient not eligible/not appropriate |
| G8952 |
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
| G8956 |
Patient receiving maintenance hemodialysis in an outpatient dialysis facility |
| G8957 |
Patient not receiving maintenance hemodialysis in an outpatient dialysis facility |
| G8961 |
Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery |
| G8962 |
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 |
| G8963 |
Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years |
| G8964 |
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) |
| G8965 |
Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment |
| G8966 |
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 |
| G8968 |
Documentation of medical reason(s) for not prescribing warfarin or another oral anticoagulant that is fda approved not prescribed (e. G. , allergy, risk of bleeding, transient or reversible causes of atrial fibrillation, other medical reasons including, but not limited to pregnancy, mitral stenosis, prosthetic heart valve or patient is in the postoperative period) |
| G8970 |
No risk factors or one moderate risk factor for thromboembolism |
| G8972 |
One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism |
| L7902 |
Tension ring, for vacuum erection device, any type, replacement only, each |
| C2624 |
Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components |
| G9435 |
Aspirin prescribed at discharge |
| G9436 |
Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed) |
| G9437 |
Aspirin not prescribed at discharge |
| G9438 |
P2y inhibitor prescribed at discharge |
| G9439 |
P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed) |
| G9440 |
P2y inhibitor not prescribed at discharge |
| G9441 |
Statin prescribed at discharge |
| G9442 |
Statin not prescribed for documented reasons (e.g., allergy, medical intolerance) |
| G9443 |
Statin not prescribed at discharge |
| J7201 |
Injection, factor ix, fc fusion protein (recombinant), per iu |
| C2623 |
Catheter, transluminal angioplasty, drug-coated, non-laser |
| C9460 |
Injection, cangrelor, 1 mg |
| G9507 |
Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (HIV protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs) |
| G9508 |
Documentation that the patient is not on a statin medication |
| G9598 |
Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted CT or minor diameter on axial formatted CT |
| G9599 |
Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted CT or minor diameter on axial formatted CT |
| G9600 |
Symptomatic AAAs that required urgent/emergent (non-elective) repair |
| G9609 |
Documentation of an order for anti-platelet agents or P2Y12 antagonists |
| G9610 |
Documentation of medical reason(s) for not ordering anti-platelet agents or P2Y12 antagonists (e.g., patients with known intolerance to anti-platelet agents such as aspirin or aspirin-like agents, or P2Y12 antagonists, or those on or other intravenous anti-coagulants; patients with active bleeding or undergoing urgent or emergent operations or endarterectomy combined with cardiac surgery, other medical reason(s)) |
| G9611 |
Order for anti-platelet agents or P2Y12 antagonists was not documented, reason not otherwise specified |
| G9641 |
Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure |
| G9662 |
Previously diagnosed or have an active diagnosis of clinical ASCVD |
| G9663 |
Any fasting or direct LDL-C laboratory test result = 190 mg/dl |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
| G9665 |
Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy |
| G9666 |
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 |
| G9667 |
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) |
| G9668 |
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) |
| G9673 |
I intend to report the cardiovascular prevention measures group |
| G9674 |
Patients with clinical ASCVD diagnosis |
| G9677 |
All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient |
| P9072 |
Platelets, pheresis, pathogen reduced, each unit |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
| C9140 |
Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u. |
| C9482 |
Injection, sotalol hydrochloride, 1 mg |
| G9680 |
This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary |
| G9687 |
Hospice services provided to patient any time during the measurement period |
| G9688 |
Patients using hospice services any time during the measurement period |
| G9689 |
Patient admitted for performance of elective carotid intervention |
| G9690 |
Patient receiving hospice services any time during the measurement period |
| G9691 |
Patient had hospice services any time during the measurement period |
| G9692 |
Hospice services received by patient any time during the measurement period |
| G9693 |
Patient use of hospice services any time during the measurement period |
| G9694 |
Hospice services utilized by patient any time during the measurement period |
| G9700 |
Patients who use hospice services any time during the measurement period |
| G9702 |
Patients who use hospice services any time during the measurement period |
| G9707 |
Patient received hospice services any time during the measurement period |
| G9709 |
Hospice services used by patient any time during the measurement period |
| G9710 |
Patient was provided hospice services any time during the measurement period |
| G9713 |
Patients who use hospice services any time during the measurement period |
| G9714 |
Patient is using hospice services any time during the measurement period |
| G9715 |
Patients who use hospice services any time during the measurement period |
| G9718 |
Hospice services for patient provided any time during the measurement period |
| G9720 |
Hospice services for patient occurred any time during the measurement period |
| G9723 |
Hospice services for patient received any time during the measurement period |
| G9724 |
Patients who had documentation of use of anticoagulant medications overlapping the measurement year |
| G9725 |
Patients who use hospice services any time during the measurement period |
| G9740 |
Hospice services given to patient any time during the measurement period |
| G9741 |
Patients who use hospice services any time during the measurement period |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
| G9745 |
Documented reason for not screening or recommending a follow-up for high blood pressure |
| G9746 |
Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery) |
| G9751 |
Patient died at any time during the 24-month measurement period |
| G9758 |
Patient in hospice and in terminal phase |
| G9760 |
Patients who use hospice services any time during the measurement period |
| G9761 |
Patients who use hospice services any time during the measurement period |
| G9768 |
Patients who utilize hospice services any time during the measurement period |
| G9781 |
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 are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, and patients with end stage renal disease (esrd)) |
| G9782 |
History of or active diagnosis of familial or pure hypercholesterolemia |
| G9788 |
Most recent bp is less than or equal to 140/90 mm hg |
| G9789 |
Blood pressure recorded during inpatient stays, emergency room visits, urgent care visits, and patient self-reported bp's (home and health fair bp results) |
| G9790 |
Most recent bp is greater than 140/90 mm hg, or blood pressure not documented |
| G9793 |
Patient is currently on a daily aspirin or other antiplatelet |
| G9794 |
Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g. history of gastrointestinal bleed or intra-cranial bleed or documentation of active anticoagulant use during the measurement period |
| G9795 |
Patient is not currently on a daily aspirin or other antiplatelet |
| G9796 |
Patient is currently on a statin therapy |
| G9797 |
Patient is not on a statin therapy |
| G9798 |
Discharge(s) for ami between july 1 of the year prior measurement year to june 30 of the measurement period |
| G9800 |
Patients who are identified as having an intolerance or allergy to beta-blocker therapy |
| G9801 |
Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis` |
| G9802 |
Patients who use hospice services any time during the measurement period |
| G9803 |
Patient prescribed a 180-day course of treatment with beta-blockers post discharge for ami |
| G9804 |
Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for ami |
| G9805 |
Patients who use hospice services any time during the measurement period |
| G9809 |
Patients who use hospice services any time during the measurement period |
| G9814 |
Death occurring during hospitalization |
| G9819 |
Patients who use hospice services any time during the measurement period |
| G9850 |
Patient had more than one emergency department visit in the last 30 days of life |
| G9851 |
Patient had one or less emergency department visits in the last 30 days of life |
| G9853 |
Patient admitted to the icu in the last 30 days of life |
| G9854 |
Patient was not admitted to the icu in the last 30 days of life |
| G9857 |
Patient admitted to hospice |
| G9858 |
Patient enrolled in hospice |
| G9860 |
Patient spent less than three days in hospice care |
| G9861 |
Patient spent greater than or equal to three days in hospice care |
| J0883 |
Injection, argatroban, 1 mg (for non-esrd use) |
| J0884 |
Injection, argatroban, 1 mg (for esrd on dialysis) |
| J7175 |
Injection, factor x, (human), 1 i.u. |
| J7179 |
Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco |
| J7202 |
Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u. |
| J7207 |
Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. |
| J7209 |
Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u. |
| G9929 |
Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery) |
| G9931 |
Documentation of cha2ds2-vasc risk score of 0 or 1 |
| G9940 |
Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year) |
| Q0477 |
Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only |