HCPCS 2013 Code Changes

Ophthalmology Print Friendly and PDF
New
Code Description
J0178 Injection, aflibercept, 1 mg
J0716 Injection, centruroides immune f(ab)2, up to 120 milligrams
J7315 Mitomycin, opthalmic, 0. 2 mg
G9376 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery
G9377 Patient did not have the retina attached after 6 months following only one surgery
G9378 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)
G9379 Patient did not achieve flat retinas six months post surgery
G9389 Unplanned rupture of the posterior capsule requiring vitrectomy
G9390 No unplanned rupture of the posterior capsule requiring vitrectomy
G9391 Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
G9392 Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit
G9393 Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five
G9394 Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period
G9395 Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five
G9396 Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)
G9516 Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
G9517 Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
G9518 Documentation of active injection drug use
G9519 Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
G9520 Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery, reason not given
G9671 I intend to report the diabetic retinopathy measures group
G9672 All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient
J7313 Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg
G9727 Patient unable to complete the foto knee intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9729 Patient unable to complete the foto hip intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9731 Patient unable to complete the foto foot or ankle intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9733 Patient unable to complete the foto lumbar intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9735 Patient unable to complete the foto shoulder intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9737 Patient unable to complete the foto elbow, wrist or hand intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9739 Patient unable to complete the foto general orthopedic intake prom at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9759 History of preoperative posterior capsule rupture
G9890 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
G9891 Documentation of medical reason(s) for not performing a dilated macular examination
G9892 Documentation of patient reason(s) for not performing a dilated macular examination
G9893 Dilated macular exam was not performed, reason not otherwise specified
G9974 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
G9975 Documentation of medical reason(s) for not performing a dilated macular examination
G9976 Documentation of patient reason(s) for not performing a dilated macular examination
G9977 Dilated macular exam was not performed, reason not otherwise specified
Revised
CodeDescriptor
G9389 Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9390 No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery
G9519 Patient achieves final refraction (spherical equivalent) +/- 0.5 diopters of their planned refraction within 90 days of surgery
G9520 Patient does not achieve final refraction (spherical equivalent) +/- 0.5 diopters of their planned refraction within 90 days of surgery
Deleted
CodeDescriptor
C9450 Injection, fluocinolone acetonide intravitreal implant, 0.01 mg
G9376 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery
G9377 Patient did not have the retina attached after 6 months following only one surgery
G9378 Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)
G9379 Patient did not achieve flat retinas six months post surgery
G9391 Patient achieves refraction +-1 D for the eye that underwent cataract surgery, measured at the one month follow up visit
G9392 Patient does not achieve refraction +-1 D for the eye that underwent cataract surgery, measured at the one month follow up visit
G8765 All quality actions for the applicable measures in the cataract measures group have been performed for this patient
G8906 I intend to report the cataract measures group
G9671 I intend to report the diabetic retinopathy measures group
G9672 All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient