HCPCS Service Codes - Medical care

HCPCS Codes for Medical care

• G2181

  Bmi not documented due to medical reason or patient refusal of height or weight measurement

• G2182

  Patient receiving first-time biologic and/or immune response modifier therapy

• G2183

  Documentation patient unable to communicate and informant not available

• G2184

  Patient does not have a caregiver

• G2185

  Documentation caregiver is trained and certified in dementia care

• G2186

  Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed

• G2187

  Patients with clinical indications for imaging of the head: head trauma

• G2188

  Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age

• G2189

  Patients with clinical indications for imaging of the head: abnormal neurologic exam

• G2190

  Patients with clinical indications for imaging of the head: headache radiating to the neck

• G2191

  Patients with clinical indications for imaging of the head: positional headaches

• G2192

  Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age

• G2193

  Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)

• G2194

  Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior

• G2195

  Patients with clinical indications for imaging of the head: occipital headache in children

• G2196

  Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method

• G2197

  Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user

• G2198

  Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons)

• G2199

  Patient not screened for unhealthy alcohol use using a systematic screening method

• G2200

  Patient identified as an unhealthy alcohol user received brief counseling

• G2201

  Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)

• G2202

  Patient did not receive brief counseling if identified as an unhealthy alcohol user

• G2203

  Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)

• G2204

  Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period

• G2205

  Patients with pregnancy during adjuvant treatment course

• G2206

  Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy

• G2207

  Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky <=50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)

• G2208

  Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy

• G2209

  Patient refused to participate

• G2210

  Residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given

• G2211

  Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to home or residence or office/outpatient evaluation and management service, new or established)

• G2212

  Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)

• G2213

  Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)

• G2214

  Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional

• G2215

  Take-home supply of nasal naloxone; 2-pack of 4mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

• G2216

  Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

• G2250

  Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment

• G2251

  Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion

• G2252

  Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion

• G3001

  Administration and supply of tositumomab, 450 mg

• G3002

  Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.)

• G3003

  Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)

• G4000

  Dermatology mips specialty set

• G4001

  Diagnostic radiology mips specialty set

• G4002

  Electrophysiology cardiac specialist mips specialty set

• G4003

  Emergency medicine mips specialty set

• G4004

  Endocrinology mips specialty set

• G4005

  Family medicine mips specialty set

• G4006

  Gastro-enterology mips specialty set

• G4007

  General surgery mips specialty set