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

  • G9250

    Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment

  • G9251

    Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment

  • G9252

    Adenoma(s) or other neoplasm detected during screening colonoscopy

  • G9253

    Adenoma(s) or other neoplasm not detected during screening colonoscopy

  • G9254

    Documentation of patient discharged to home later than post-operative day 2 following cea or cas

  • G9255

    Documentation of patient discharged to home no later than post operative day 2 following cea or cas

  • G9256

    Documentation of patient death following cas

  • G9257

    Documentation of patient stroke following cas

  • G9258

    Documentation of patient stroke following cea

  • G9259

    Documentation of patient survival and absence of stroke following cas

  • G9260

    Documentation of patient death following cea

  • 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)