| New |
| Code |
Description |
| G0452 |
Molecular pathology procedure; physician interpretation and report |
| G8973 |
Most recent hemoglobin (hgb) level < 10 g/dl |
| G8974 |
Hemoglobin level measurement not documented, reason not given |
| G8975 |
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) |
| G8976 |
Most recent hemoglobin (hgb) level >= 10 g/dl |
| G0461 |
Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain |
| G0462 |
Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) |
| G9202 |
Patients with a positive hepatitis c antibody test |
| G9214 |
Cd4+ cell count or cd4+ cell percentage results documented |
| G9215 |
Cd4+ cell count or percentage not documented as performed, reason not given |
| G9220 |
Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
| G9221 |
Pneumocystis jiroveci pneumonia prophlaxis prescribed |
| G9223 |
Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% |
| G9228 |
Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) |
| G9230 |
Chlamydia, gonorrhea, and syphilis not screened, reason not given |
| G9242 |
Documentation of viral load equal to or greater than 200 copies/ml |
| G9243 |
Documentation of viral load less than 200 copies/ml |
| G9271 |
Ldl value < 100 |
| G9272 |
Ldl value >= 100 |
| G9279 |
Pneumococcal screening performed and documentation of vaccination received prior to discharge |
| G9280 |
Pneumococcal vaccination not administered prior to discharge, reason not specified |
| G9281 |
Screening performed and documentation that vaccination not indicated/patient refusal |
| G9282 |
Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons) |
| G9283 |
Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9284 |
Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9285 |
Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer |
| G9288 |
Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons ) |
| G9289 |
Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9290 |
Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9291 |
Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos |
| G9293 |
Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| G9294 |
Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| L1 |
Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps |
| G0464 |
Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3) |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
| G6030 |
Amitriptyline |
| G6031 |
Benzodiazepines |
| G6032 |
Desipramine |
| G6034 |
Doxepin |
| G6035 |
Gold |
| G6036 |
Assay of imipramine |
| G6037 |
Nortriptyline |
| G6038 |
Salicylate |
| G6039 |
Acetaminophen |
| G6040 |
Alcohol (ethanol); any specimen except breath |
| G6041 |
Alkaloids, urine, quantitative |
| G6042 |
Amphetamine or methamphetamine |
| G6043 |
Barbiturates, not elsewhere specified |
| G6044 |
Cocaine or metabolite |
| G6045 |
Dihydrocodeinone |
| G6046 |
Dihydromorphinone |
| G6047 |
Dihydrotestosterone |
| G6048 |
Dimethadione |
| G6049 |
Epiandrosterone |
| G6050 |
Ethchlorvynol |
| G6051 |
Flurazepam |
| G6052 |
Meprobamate |
| G6053 |
Methadone |
| G6054 |
Methsuximide |
| G6055 |
Nicotine |
| G6056 |
Opiate(s), drug and metabolites, each procedure |
| G6057 |
Phenothiazine |
| G6058 |
Drug confirmation, each procedure |
| G9383 |
Patient received screening for hcv infection within the 12 month reporting period |
| G9384 |
Documentation of medical reason(s) for not receiving screening for hcv infection within the 12 month reporting period (e.g., decompensated cirrhosis including advanced disease [ie, ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, or waitlist for organ transplant, limited life expectancy, other medical reasons) |
| G9385 |
Documentation of patient reason(s) for not receiving screening for hcv infection within the 12 month reporting period (e.g., patient declined, other patient reasons) |
| G9386 |
Screening for hcv infection not received within the 12 month reporting period, reason not given |
| G9428 |
Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| G9429 |
Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons) |
| G9430 |
Specimen site other than anatomic cutaneous location |
| G9431 |
Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| G0298 |
HIV antigen/antibody, combination assay, screening |
| G0475 |
HIV antigen/antibody, combination assay, screening |
| G0476 |
Infectious agent detection by nucleic acid (DNA or RNA); human papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
| G9618 |
Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind |
| G9649 |
Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (PGA; 6-point scale), body surface area (BSA), psoriasis area and severity index (PASI) and/or der life quality index) (DLQI)) |
| G9651 |
Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (PGA; 6-point scale), body surface area (BSA), psoriasis area and severity index (PASI) and/or der life quality index) (DLQI)) or psoriasis assessment tool not documented |
| G9659 |
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 |
| G9660 |
Documentation of medical reason(s) for a colonoscopy performed on a patient greater than 85 years of age (eg., 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) |
| G9661 |
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 diagnoses advance lesions |
| G9663 |
Any fasting or direct LDL-C laboratory test result = 190 mg/dl |
| 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 |
| 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) |
| G9675 |
Patients who have ever had a fasting or direct laboratory result of LDL-C = 190 mg/dl |
| G9676 |
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 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag) followed by a neutralizing confirmatory test for initially reactive results, and antibodies to hbsag (anti-hbs) and hepatitis b core antigen (anti-hbc) |
| G9783 |
Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy |
| G9784 |
Pathologists/dermatopathologists providing a second opinion on a biopsy |
| G9785 |
Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsying clinician for review within 7 business days from the time when the tissue specimen was received by the pathologist |
| G9786 |
Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the biopsying clinician for review within 7 business days from the time when the tissue specimen was received by the pathologist |
| G9806 |
Patients who received cervical cytology or an hpv test |
| G9807 |
Patients who did not receive cervical cytology or an hpv test |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
| G9821 |
No documentation of a chlamydia screening test with proper follow-up |
| G9823 |
Endometrial sampling or hysteroscopy with biopsy and results documented |
| G9824 |
Endometrial sampling or hysteroscopy with biopsy and results not documented |
| G9825 |
Her-2/neu negative or undocumented/unknown |
