HCPCS Range Additional Assorted Quality Measures

• 1 RAS (KRAS and NRAS) gene mutation ( G9843 )

• 2 RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR moab ( G9841 )

• 3 RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR moab ( G9840 )

• 4 Beta-blocker therapy not prescribed, reason not given ( G9188 )

• 5 Beta-blocker therapy prescribed or currently being taken ( G9189 )

• 6 Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons) ( G9190 )

• 7 Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons) ( G9191 )

• 8 DSM-IVTM criteria for major depressive disorder documented at the initial evaluation ( G9212 )

• 9 DSM-IV-TR criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified ( G9213 )

• 10 Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low CD4+ cell count below 500 cells/mm3 or a CD4 percentage below 15% ( G9223 )

• 11 Foot exam was not performed, reason not given ( G9225 )

• 12 Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) ( G9226 )

• 13 Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (ITP), gastric bypass or documentation of active anticoagulant use during the measurement period) ( G9794 )

• 14 Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) ( G9228 )

• 15 Chlamydia, gonorrhea, and syphilis not screened, reason not given ( G9230 )

• 16 Documentation of end stage renal disease (ESRD), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period ( G9231 )

• 17 Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed ( G9242 )

• 18 Documentation of viral load less than 200 copies/ml ( G9243 )

• 19 Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart ( G9246 )

• 20 Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart ( G9247 )

• 21 Documentation of patient discharged to home later than post-operative day 2 following cea or cas ( G9254 )

• 22 Documentation of patient discharged to home no later than post operative day 2 following cea or cas ( G9255 )

• 23 Blood pressure has a systolic value of < 140 and a diastolic value of < 90 ( G9273 )

• 24 Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90 ( G9274 )

• 25 Documentation that patient is a current non-tobacco user ( G9275 )

• 26 Documentation that patient is a current tobacco user ( G9276 )

• 27 Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux) ( G9277 )

• 28 Documentation that the patient is not on daily aspirin or anti-platelet regimen ( G9278 )

• 29 Pneumococcal screening performed and documentation of vaccination received prior to discharge ( G9279 )

• 30 Pneumococcal vaccination not administered prior to discharge, reason not specified ( G9280 )

• 31 Screening performed and documentation that vaccination not indicated/patient refusal ( G9281 )

• 32 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) ( G9282 )

• 33 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as NSCLC-NOS with an explanation ( G9283 )

• 34 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 ( G9284 )

• 35 Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer ( G9285 )

• 36 Antibiotic regimen prescribed within10 days after onset of symptoms ( G9286 )

• 37 Antibiotic regimen not prescribed within 10 days after onset of symptoms ( G9287 )

• 38 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 ) ( G9288 )

• 39 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as NSCLC-NOS with an explanation ( G9289 )

• 40 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 ( G9290 )

• 41 Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as NSCLC-NOS ( G9291 )

• 42 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) ( G9292 )

• 43 Pathology report does not include the pt category and a statement on thickness and ulceration and for PT1, mitotic rate ( G9293 )

• 44 Pathology report includes the pt category and a statement on thickness and ulceration and for PT1, mitotic rate ( G9294 )

• 45 Specimen site other than anatomic cutaneous location ( G9295 )

• 46 Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure ( G9296 )

• 47 Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given ( G9297 )

• 48 Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g. history of DVT, PE, MI, arrhythmia and stroke) ( G9298 )

• 49 Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given) ( G9299 )

• 50 Intervention for presence of leak of endoluminal contents through an anastomosis not required ( G9305 )

• 51 Intervention for presence of leak of endoluminal contents through an anastomosis required ( G9306 )

• 52 No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure ( G9307 )

• 53 Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure ( G9308 )

• 54 No unplanned hospital readmission within 30 days of principal procedure ( G9309 )

• 55 Unplanned hospital readmission within 30 days of principal procedure ( G9310 )

• 56 No surgical site infection ( G9311 )

• 57 Surgical site infection ( G9312 )

• 58 Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist ( G9785 )

• 59 Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist ( G9786 )

• 60 Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given ( G9314 )

• 61 Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis ( G9315 )

• 62 Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family ( G9316 )

• 63 Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed ( G9317 )

• 64 Imaging study named according to standardized nomenclature ( G9318 )

• 65 Imaging study not named according to standardized nomenclature, reason not given ( G9319 )

• 66 Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion or infarct avid imaging) studies documented in the 12-month period prior to the current study ( G9321 )

• 67 Count of previous ct and cardiac nuclear medicine (myocardial perfusion or infarct avid imaging) studies not documented in the 12-month period prior to the current study, reason not given ( G9322 )

• 68 Search conducted for prior patient CT studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed ( G9341 )

• 69 Search not conducted prior to an imaging study being performed for prior patient CT studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given ( G9342 )

• 70 Due to system reasons search not conducted for dicom format images for prior patient CT imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system) ( G9344 )

• 71 Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up CT imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors ( G9345 )

• 72 Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given ( G9347 )

• 73 More than one CT scan of the paranasal sinuses ordered or received within 90 days after diagnosis ( G9351 )

• 74 More than one CT scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given ( G9352 )

• 75 More than one CT scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (e.g., patients with complications, second CT obtained prior to surgery, other medical reasons) ( G9353 )

• 76 One CT scan or no CT scan of the paranasal sinuses ordered within 90 days after the date of diagnosis ( G9354 )

• 77 Elective delivery (without medical indication) by cesarean birth or induction of labor not performed (<39 weeks of gestation) ( G9355 )

• 78 Elective delivery (without medical indication) by cesarean birth or induction of labor performed (<39 weeks of gestation) ( G9356 )

• 79 Post-partum screenings, evaluations and education performed ( G9357 )

• 80 Post-partum screenings, evaluations and education not performed ( G9358 )

• 81 Sinusitis caused by, or presumed to be caused by, bacterial infection ( G9364 )

• 82 At least two orders for high-risk medications from the same drug class ( G9367 )

• 83 At least two orders for high-risk medications from the same drug class not ordered ( G9368 )

• 84 Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period ( G9380 )

• 85 Patient not offered assistance with end of life issues or existing end of life plan was not reviewed or updated during the measurement period ( G9382 )

• 86 Patient received screening for HCV infection within the 12 month reporting period ( G9383 )

• 87 Documentation of medical reason(s) for not receiving annual screening for HCV infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons) ( G9384 )

• 88 Documentation of patient reason(s) for not receiving annual screening for HCV infection (e.g., patient declined, other patient reasons) ( G9385 )

• 89 Screening for HCV infection not received within the 12 month reporting period, reason not given ( G9386 )

• 90 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 ( G9393 )

• 91 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 ( G9394 )

• 92 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 ( G9395 )

• 93 Patient with an initial PHQ-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days) ( G9396 )

• 94 Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days ( G9408 )

• 95 Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days ( G9409 )

• 96 Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision ( G9410 )

• 97 Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision ( G9411 )

• 98 Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision ( G9412 )

• 99 Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision ( G9413 )

• 100 Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays ( G9414 )

• 101 Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays ( G9415 )

• 102 Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (TDAP) on or between the patient's 10th and 13th birthdays ( G9416 )

• 103 Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (TDAP) on or between the patient's 10th and 13th birthdays ( G9417 )

• 104 Primary non-small cell lung cancer lung biopsy and cytology specimen report documents classification into specific histologic type following iaslc guidance or classified as nsclc-nos with an explanation ( G9418 )

• 105 Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g. specimen insufficient or non-diagnostic, specimen does not contain cancer, or other documented medical reasons) ( G9419 )

• 106 Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer ( G9420 )

• 107 Primary non-small cell lung cancer lung biopsy and cytology specimen report does not document classification into specific histologic type or histologic type does not follow iaslc guidance or is classified as nsclc-nos but without an explanation ( G9421 )

• 108 Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma and not nsclc-nos) ( G9422 )

• 109 Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)] ( G9423 )

• 110 Specimen site other than anatomic location of lung, is not classified as non-small cell lung cancer or classified as NSCLC-NOS ( G9424 )

• 111 Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma) ( G9425 )

• 112 Improvement in median time from ED arrival to initial ED oral or parenteral pain medication administration performed for ED admitted patients ( G9426 )

• 113 Improvement in median time from ED arrival to initial ED oral or parenteral pain medication administration not performed for ED admitted patients ( G9427 )

• 114 Pathology report includes the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors ( G9428 )

• 115 Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons) ( G9429 )

• 116 Specimen site other than anatomic cutaneous location ( G9430 )

• 117 Pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors ( G9431 )

• 118 Asthma well-controlled based on the ACT, C-ACT, ACQ, or ATAQ score and results documented ( G9432 )

• 119 Asthma not well-controlled based on the ACT, C-ACT, ACQ, or ATAQ score, or specified asthma control tool not used, reason not given ( G9434 )

• 120 Documentation of medical reason(s) for not receiving hcv antibody test due to limited life expectancy ( G9452 )

• 121 Patient underwent abdominal imaging with ultrasound, contrast enhanced CT or contrast MRI for HCC ( G9455 )

• 122 Documentation of medical or patient reason(s) for not ordering or performing screening for HCC. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment) ( G9456 )

• 123 Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period ( G9457 )

• 124 Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills ( G9468 )

• 125 Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600mg prednisone or greater for all fills ( G9470 )

• 126 Within the past 2 years, central dual-energy X-ray absorptiometry (DXA) not ordered or documented ( G9471 )

• 127 Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)] ( G9361 )

• 128 Patients with clinical ASCVD diagnosis ( G9674 )

• 129 Patients who have ever had a fasting or direct laboratory result of LDL-C = 190 mg/dl ( G9675 )

• 130 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 )

• 131 Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy ( G9665 )

• 132 Patients who are currently statin therapy users or received an order (prescription) for statin therapy ( G9664 )

• 133 Any ldl-c laboratory result >= 190 mg/dl ( G9663 )

• 134 Previously diagnosed or have a diagnosis of clinical ascvd, including ascvd procedure ( G9662 )

• 135 Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits) ( G9660 )

• 136 Patients greater than or equal to 86 years of age who received a colonoscopy for an assessment of signs/symptoms of gi tract illness, and/or because the patient meets high risk criteria, and/or to follow-up on previously diagnosed advanced lesions ( G9661 )

• 137 Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits ( G9659 )

• 138 A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used ( G9658 )

• 139 Monitored anesthesia care (MAC) ( G9654 )

• 140 A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used ( G9655 )

• 141 Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) ( G9637 )

• 142 Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) or psoriasis assessment tool not documented ( G9651 )

• 143 Patients with 90 day MRS score greater than 2 ( G9648 )

• 144 Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) ( G9649 )

• 145 Patients with 90 day MRS score of 0 to 2 ( G9646 )

• 146 Current smoker (e.g., cigarette, cigar, pipe, e-cigarette or marijuana) ( G9642 )

• 147 Elective surgery ( G9643 )

• 148 Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure ( G9644 )

• 149 Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure ( G9645 )

• 150 Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) ( G9638 )

• 151 Patient transferred directly from anesthetizing location to PASU or other non-ICU location ( G9656 )

• 152 Patient in hospice at any time during the measurement period ( G9758 )

• 153 Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient's 9th and 13th birthdays ( G9762 )

• 154 Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery ( G9630 )

• 155 Patient sustained bowel injury at the time of surgery or discovered subsequently up to 30 days post-surgery ( G9628 )

• 156 Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury) ( G9629 )

• 157 Patient sustained bladder injury at the time of surgery or discovered subsequently up to 30 days post-surgery ( G9625 )

• 158 Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury) ( G9626 )

• 159 Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 30 days post-surgery ( G9627 )

• 160 Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method ( G9622 )

• 161 Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling ( G9621 )

• 162 Order for anti-platelet agents was not documented in the patient's record, reason not given ( G9611 )

• 163 Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents ( G9610 )

• 164 Documentation of an order for anti-platelet agents ( G9609 )

• 165 Intraoperative cystoscopy not performed to evaluate for lower tract injury ( G9608 )

• 166 Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient's 9th and 13th birthdays ( G9763 )

• 167 Patient survey results not available ( G9604 )

• 168 Patient survey score did not improve from baseline following treatment ( G9605 )

• 169 Intraoperative cystoscopy performed to evaluate for lower tract injury ( G9606 )

• 170 Patient survey score improved from baseline following treatment ( G9603 )

• 171 Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted CT or minor diameter on axial formatted CT ( G9599 )

• 172 Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules ( G9597 )

• 173 Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted CT or minor diameter on axial formatted CT ( G9598 )

• 174 Patient has documentation of ventricular shunt, brain tumor, or coagulopathy ( G9595 )

• 175 Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider ( G9594 )

• 176 Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules ( G9593 )

• 177 Door to puncture time of greater than 90 minutes, no reason given ( G9582 )

• 178 Door to puncture time of 90 minutes or less ( G9580 )

• 179 Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging not recommended ( G9556 )

• 180 Final reports for ct, cta, mri or mra studies of the chest or neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found ( G9557 )

• 181 Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s)) ( G9555 )

• 182 Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s)) ( G9549 )

• 183 Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up ( G9550 )

• 184 Final reports for imaging studies without an incidentally found lesion noted ( G9551 )

• 185 Incidental thyroid nodule < 1.0 cm noted in report ( G9552 )

• 186 Prior thyroid disease diagnosis ( G9553 )

• 187 Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended ( G9554 )

• 188 Final reports for imaging studies stating no follow-up imaging is recommended ( G9548 )

• 189 Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols ( G9547 )

• 190 Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement ( G9543 )

• 191 Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement ( G9544 )

• 192 Intent for potential removal at time of placement ( G9539 )

• 193 Patient alive 3 months post procedure ( G9540 )

• 194 Filter removed within 3 months of placement ( G9541 )

• 195 Documented re-assessment for the appropriateness of filter removal within 3 months of placement ( G9542 )

• 196 Imaging needed as part of a clinical trial; or other clinician ordered the study ( G9537 )

• 197 Patient with minor blunt head trauma did not have an appropriate indication(s) for a head CT ( G9533 )

• 198 Patient with minor blunt head trauma had an appropriate indication(s) for a head CT ( G9529 )

• 199 Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider ( G9530 )

• 200 Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar ( G9531 )

• 201 Documentation of active injection drug use ( G9518 )

• 202 Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery ( G9519 )

• 203 Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery ( G9520 )

• 204 Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months ( G9521 )

• 205 Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given ( G9522 )

• 206 Patient did not require a return to the operating room within 90 days of surgery ( G9515 )

• 207 Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery ( G9516 )

• 208 Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given ( G9517 )

• 209 Individual had a PDC of 0.8 or greater ( G9512 )

• 210 Individual did not have a PDC of 0.8 or greater ( G9513 )

• 211 Patient required a return to the operating room within 90 days of surgery ( G9514 )

• 212 Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period ( G9511 )

• 213 Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5 ( G9510 )

• 214 Documentation that the patient is not on a statin medication ( G9508 )

• 215 Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5 ( G9509 )

• 216 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) ( G9507 )

• 217 Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason ( G9505 )

• 218 Patient has been treated with a systemic medication for psoriasis vulgaris ( G9764 )

• 219 Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi ( G9765 )

• 220 Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period) ( G9502 )

• 221 Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given ( G9501 )

• 222 Radiation exposure indices documented in final report for procedure using fluoroscopy ( G9500 )

• 223 Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery ( G9497 )

• 224 Antibiotic regimen prescribed ( G9498 )

• 225 Admission to medicare care choice model program (MCCM) ( G9480 )

• 226 Services performed by qualified pharmacist in the hospice setting, each 15 minutes ( G9479 )

• 227 Services performed by other qualified therapist in the hospice setting, each 15 minutes ( G9478 )

• 228 Services performed by care coordinator in the hospice setting, each 15 minutes ( G9477 )

• 229 Services performed by volunteer in the hospice setting, each 15 minutes ( G9476 )

• 230 Services performed by other counselor in the hospice setting, each 15 minutes ( G9475 )

• 231 Services performed by dietary counselor in the hospice setting, each 15 minutes ( G9474 )

• 232 Services performed by chaplain in the hospice setting, each 15 minutes ( G9473 )

• 233 CMS innovation center models, 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 in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code ( G9490 )

• 234 Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9481 )

• 235 Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9482 )

• 236 Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9483 )

• 237 Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9484 )

• 238 Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9485 )

• 239 Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9486 )

• 240 Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9487 )

• 241 Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9488 )

• 242 Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, 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 ( G9489 )

• 243 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 )

• 244 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 )

• 245 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 )

• 246 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 )

• 247 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 )

• 248 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 )

• 249 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 )

• 250 Hospice services provided to patient any time during the measurement period ( G9687 )

• 251 Patients using hospice services any time during the measurement period ( G9688 )

• 252 Patient admitted for performance of elective carotid intervention ( G9689 )

• 253 Patient receiving hospice services any time during the measurement period ( G9690 )

• 254 Patient had hospice services any time during the measurement period ( G9691 )

• 255 Hospice services received by patient any time during the measurement period ( G9692 )

• 256 Patient use of hospice services any time during the measurement period ( G9693 )

• 257 Hospice services UTIlized by patient any time during the measurement period ( G9694 )

• 258 Long-acting inhaled bronchodilator prescribed ( G9695 )

• 259 Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects) ( G9696 )

• 260 Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., cost of treatment or lack of insurance) ( G9698 )

• 261 Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified ( G9699 )

• 262 Patients who use hospice services any time during the measurement period ( G9700 )

• 263 Patients who use hospice services any time during the measurement period ( G9702 )

• 264 Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date ( G9703 )

• 265 AJCC breast cancer stage i: t1 mic or t1a documented ( G9704 )

• 266 AJCC breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented ( G9705 )

• 267 Low (or very low) risk of recurrence, prostate cancer ( G9706 )

• 268 Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy ( G9708 )

• 269 Hospice services used by patient any time during the measurement period ( G9709 )

• 270 Patient was provided hospice services any time during the measurement period ( G9710 )

• 271 Patients with a diagnosis or past history of total colectomy or colorectal cancer ( G9711 )

• 272 Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/UTI, acne, HIV disease/asymptomatic HIV, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis ( G9712 )

• 273 Patients who use hospice services any time during the measurement period ( G9713 )

• 274 Patient is using hospice services any time during the measurement period ( G9714 )

• 275 Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason ( G9716 )

• 276 Documentation stating the patient has had a diagnosis of bipolar disorder ( G9717 )

• 277 Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair ( G9719 )

• 278 Hospice services for patient occurred any time during the measurement period ( G9720 )

• 279 Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair ( G9721 )

• 280 Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher ( G9722 )

• 281 Hospice services for patient received any time during the measurement period ( G9723 )

• 282 Patients who had documentation of use of anticoagulant medications overlapping the measurement year ( G9724 )

• 283 Patient refused to participate ( G9726 )

• 284 Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9727 )

• 285 Patient refused to participate ( G9728 )

• 286 Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9729 )

• 287 Patient refused to participate ( G9730 )

• 288 Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9731 )

• 289 Patient refused to participate ( G9732 )

• 290 Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9733 )

• 291 Patient refused to participate ( G9734 )

• 292 Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9735 )

• 293 Patient refused to participate ( G9736 )

• 294 Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available ( G9737 )

• 295 Hospice services given to patient any time during the measurement period ( G9740 )

• 296 Patients who use hospice services any time during the measurement period ( G9741 )

• 297 Patient not eligible due to active diagnosis of hypertension ( G9744 )

• 298 Documented reason for not screening or recommending a follow-up for high blood pressure ( G9745 )

• 299 Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery) ( G9746 )

• 300 Emergency surgery ( G9752 )

• 301 Documentation of medical reason for not conducting a search for dicom format images for prior patient CT imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared arcHIVe (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence) ( G9753 )

• 302 A finding of an incidental pulmonary nodule ( G9754 )

• 303 Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection) ( G9755 )

• 304 Surgical procedures that included the use of silicone oil ( G9756 )

• 305 Surgical procedures that included the use of silicone oil ( G9757 )

• 306 Patients who use hospice services any time during the measurement period ( G9761 )

• 307 Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user ( G9624 )

• 308 Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death ( G9607 )

• 309 Documented reason for not assessing hepatitis B virus (HBV) status (e.g., patient not initiating anti-TNF therapy, patient declined) prior to initiating anti-TNF therapy ( G9504 )

• 310 Patients who are transferred from one institUTIon to another with a known diagnosis of CVA for endovascular stroke treatment ( G9766 )

• 311 Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment ( G9767 )

• 312 Patients who UTIlize hospice services any time during the measurement period ( G9768 )

• 313 Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months ( G9769 )

• 314 Peripheral nerve block (PNB) ( G9770 )

• 315 At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time ( G9771 )

• 316 Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.) ( G9772 )

• 317 At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time, reason not given ( G9773 )

• 318 Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively ( G9775 )

• 319 Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason) ( G9776 )

• 320 Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively ( G9777 )

• 321 Patients who are breastfeeding at any time during the performance period ( G9779 )

• 322 Patients who have a diagnosis of rhabdomyolysis at any time during the performance period ( G9780 )

• 323 Documentation of medical reason(s) for not currently being a statin therapy user or receiving an order (prescription) for statin therapy (e.g., patients with statin-associated muscle symptoms or an allergy to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease [esrd], or other medical reasons) ( G9781 )

• 324 History of or active diagnosis of familial hypercholesterolemia ( G9782 )

• 325 Pathologists/dermatopathologists providing a second opinion on a biopsy ( G9784 )

• 326 Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason ( G9313 )

• 327 Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter ( G9227 )

• 328 Patient alive as of the last day of the measurement year ( G9787 )

• 329 Most recent bp is less than or equal to 140/90 mm hg ( G9788 )

• 330 Blood pressure recorded during inpatient stays, emergency room visits, or urgent care visits ( G9789 )

• 331 Most recent bp is greater than 140/90 mm hg, or blood pressure not documented ( G9790 )

• 332 Most recent tobacco status is tobacco free ( G9791 )

• 333 Most recent tobacco status is not tobacco free ( G9792 )

• 334 Patient is currently on a daily aspirin or other antiplatelet ( G9793 )

• 335 Patient is not currently on a daily aspirin or other antiplatelet ( G9795 )

• 336 Patient is currently on a statin therapy ( G9796 )

• 337 Patient is not on a statin therapy ( G9797 )

• 338 Patients who use hospice services any time during the measurement period ( G9805 )

• 339 Patients who received cervical cytology or an HPV test ( G9806 )

• 340 Patients who did not receive cervical cytology or an HPV test ( G9807 )

• 341 Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure ( G9812 )

• 342 Patient did not die within 30 days of the procedure or during the index hospitalization ( G9813 )

• 343 Documentation of sexual activity ( G9818 )

• 344 Patients who use hospice services any time during the measurement period ( G9819 )

• 345 Documentation of a chlamydia screening test with proper follow-up ( G9820 )

• 346 No documentation of a chlamydia screening test with proper follow-up ( G9821 )

• 347 Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date) ( G9822 )

• 348 Endometrial sampling or hysteroscopy with biopsy and results documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation ( G9823 )

• 349 Endometrial sampling or hysteroscopy with biopsy and results not documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation ( G9824 )

• 350 HER-2/neu positive ( G9830 )

• 351 AJCC Stage at breast cancer diagnosis = II Or III ( G9831 )

• 352 AJCC Stage at breast cancer diagnosis = I (Ia Or Ib) And t-Stage At breast cancer diagnosis does not equal = T1, T1A, T1B ( G9832 )

• 353 Patient has metastatic disease at diagnosis ( G9838 )

• 354 Anti-EGFR monoclonal antibody therapy ( G9839 )

• 355 Patient has metastatic disease at diagnosis ( G9842 )

• 356 Patient did not receive Anti-EGFR monoclonal antibody therapy ( G9844 )

• 357 Patient received Anti-EGFR monoclonal antibody therapy ( G9845 )

• 358 Patients who died from cancer ( G9846 )

• 359 Patient received systemic cancer-directed therapy in the last 14 days of life ( G9847 )

• 360 Patient did not receive systemic cancer-directed therapy in the last 14 days of life ( G9848 )

• 361 Patient enrolled in hospice ( G9858 )

• 362 Patients who died from cancer ( G9859 )

• 363 Patient spent less than three days in hospice care ( G9860 )

• 364 Patient spent greater than or equal to three days in hospice care ( G9861 )

• 365 Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons) ( G9862 )

• 366 Bridge Payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session, core maintenance session, or ongoing maintenance session furnished by an MDPP supplier to an MDPP beneficiary during months 1-24 of the MDPP Expanded Model (EM) who has previously received MDPP services from a different MDPP supplier under the MDPP Expanded Model. A supplier may only receive one bridge payment per MDPP beneficiary. ( G9890 )

• 367 MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model and counting toward achievement of the attendance performance goal for the payable MDPP Expanded Model HCPCS code.(This code is for reporting purposes only). ( G9891 )

• 368 First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions ( G9873 )

• 369 Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions. ( G9874 )

• 370 Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions ( G9875 )

• 371 Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary did not achieve at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9. ( G9876 )

• 372 Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary did not achieve at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12. ( G9877 )

• 373 Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions.The beneficiary achieved at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9. ( G9878 )

• 374 Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions.The beneficiary achieved at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12 ( G9879 )

• 375 The MDPP beneficiary achieved at least 5% weight loss (WL) from his/her baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM). This is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session. ( G9880 )

• 376 The MDPP beneficiary achieved at least 9% weight loss (WL) from his/her baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session. ( G9881 )

• 377 Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions.The beneficiary maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15. ( G9882 )

• 378 Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18. ( G9883 )

• 379 Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21. ( G9884 )

• 380 Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24. ( G9885 )

• 381 Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes ( G9868 )

• 382 Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes ( G9869 )

• 383 Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes ( G9870 )

• 384 Behavioral counseling for diabetes prevention, in-person, group, 60 minutes ( G9886 )

• 385 Behavioral counseling for diabetes prevention, distance learning, 60 minutes ( G9887 )

• 386 Maintenance 5% wl from baseline weight in months 7-12 ( G9888 )