Showing codes G9935 (Adenoma(s) or colorectal cancer not detected during screening colonoscopy) — G9969 (Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred)
G9935 - Canc not detectd during srcn
Long description: Adenoma(s) or colorectal cancer not detected during screening colonoscopy
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9936 - Pmh plyp/neo co/rect/jun/ans
Long description: Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9937 - Dig or surv colsco
Long description: Diagnostic colonoscopy
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9938 - Pt 66+ snp or ltc pos > 90d
Long description: Patients aged 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period
Code added date: 20180101.
Code effective date: 20240101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9939 - Same path/derm perf biopsy
Long description: Pathologists/dermatopathologists is the same clinician who performed the biopsy
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9940 - Doc reas no statin therapy
Long description: 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)
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9941 - Pre and post vas wthn 3 mos
Long description: Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
Code added date: 20180101.
Code effective date: 20200101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9942 - Adtl spine proc on same date
Long description: Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9943 - Bk pn nt msr vas scl pre/pst
Long description: Back pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9944 - Vas 3 mon pre and 1 yr post
Long description: Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
Code added date: 20180101.
Code effective date: 20200101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9945 - Pt w/cancer scoliosis
Long description: Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9946 - Bk pain no vas
Long description: Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9947 - Pre and post vas wthn 3 mos
Long description: Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
Code added date: 20180101.
Code effective date: 20200101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9948 - Adtl spine proc on same date
Long description: Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9949 - Leg pain no vas
Long description: Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9954 - Pt >2 rsk fac post-op vomit
Long description: Patient exhibits 2 or more risk factors for post-operative vomiting
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9955 - Inhlnt anesth only for induc
Long description: Cases in which an inhalational anesthetic is used only for induction
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9956 - Combo thrpy of >= 2 prophly
Long description: Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9957 - Doc med rsn no combo thrpy
Long description: Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9958 - No combo prohpyl thrp for pt
Long description: Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9959 - Systemic antimicro not presc
Long description: Systemic antimicrobials not prescribed
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9960 - Med rsn sys antimi nt rx
Long description: Documentation of medical reason(s) for prescribing systemic antimicrobials
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G9961 - Systemic antimicro presc
Long description: Systemic antimicrobials prescribed
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9962 - Embolization doc separatly
Long description: Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9963 - Embolization not doc separat
Long description: Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9964 - Pt recv >=1 well-chld visit
Long description: Patient received at least one well-child visit with a pcp during the performance period
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9965 - No well-chld vist recv by pt
Long description: Patient did not receive at least one well-child visit with a pcp during the performance period
Code added date: 20180101.
Code effective date: 20180101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9966 - Scrn, inter, report child
Long description: Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9967 - No scrn, inter, reprt child
Long description: Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
Code added date: 20180101.
Code effective date: 20210101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9968 - Pt refrd 2 pvdr/spclst in pp
Long description: Patient was referred to another clinician or specialist during the measurement period
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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PDF
G9969 - Pvdr rfrd pt rprt rcvd
Long description: Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred
Code added date: 20180101.
Code effective date: 20230101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML
PDF