HCPCS Service Codes - Medical care

HCPCS Service Code 1 for Medical care.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Medical care

  • G9261

    Documentation of patient survival and absence of stroke following cea

  • G9262

    Documentation of patient death in the hospital following endovascular aaa repair

  • G9263

    Documentation of patient discharged alive following endovascular aaa repair

  • G9264

    Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)

  • G9265

    Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access

  • G9266

    Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access

  • G9267

    Documentation of patient with one or more complications or mortality within 30 days

  • G9268

    Documentation of patient with one or more complications within 90 days

  • G9269

    Documentation of patient without one or more complications and without mortality within 30 days

  • G9270

    Documentation of patient without one or more complications within 90 days

  • G9271

    Ldl value < 100

  • G9272

    Ldl value >= 100

  • G9273

    Blood pressure has a systolic value of < 140 and a diastolic value of < 90

  • G9274

    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

  • G9275

    Documentation that patient is a current non-tobacco user

  • G9276

    Documentation that patient is a current tobacco user

  • G9277

    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)

  • G9278

    Documentation that the patient is not on daily aspirin or anti-platelet regimen

  • G9279

    Pneumococcal screening performed and documentation of vaccination received prior to discharge

  • G9280

    Pneumococcal vaccination not administered prior to discharge, reason not specified

  • G9281

    Screening performed and documentation that vaccination not indicated/patient refusal

  • G9282

    Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)

  • G9283

    Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

  • G9284

    Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation

  • G9285

    Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer

  • G9286

    Antibiotic regimen prescribed within 10 days after onset of symptoms

  • G9287

    Antibiotic regimen not prescribed within 10 days after onset of symptoms

  • G9288

    Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)

  • G9289

    Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

  • G9290

    Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation

  • G9291

    Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos

  • G9292

    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)

  • G9293

    Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

  • G9294

    Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate

  • G9295

    Specimen site other than anatomic cutaneous location

  • G9296

    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

  • G9297

    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

  • G9298

    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)

  • G9299

    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)

  • G9300

    Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)

  • G9301

    Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet

  • G9302

    Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given

  • G9303

    Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given

  • G9304

    Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant

  • G9305

    Intervention for presence of leak of endoluminal contents through an anastomosis not required

  • G9306

    Intervention for presence of leak of endoluminal contents through an anastomosis required

  • G9307

    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

  • G9308

    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

  • G9309

    No unplanned hospital readmission within 30 days of principal procedure

  • G9310

    Unplanned hospital readmission within 30 days of principal procedure