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2018 New CPT codes

00731  Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified ...

2013 CHANGED CODES



A6021     Collagen dressing, sterile, size 16 sq in or less, each 

A6022      Collagen dressing, sterile, size more then 16 sq in but less than or equal to 48 sq in. each 

A6023     Collagen dressing, sterile, size more than 48 sq in, each 

C9724       Endoscopic full-thickness plication of the stomach using endoscopic plication system (EPS); includes endoscopy 

E0300      Pediatric crib, hospital grade, fully enclosed, with or without top enclosure

E1020      Residual limb support system for wheelchair, any type 

E2368      Power wheelchair component, drive wheel motor, replacement only

E2369      Power wheelchair component, drive wheel gear box, replacement only

E2370      power wheelchair component, integrated drive wheel motor and gear box combination, replacement only

G0416      Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 10-20 specimens 

G0446      Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes 

G0909     Hemoglobin level measurement not documented, reason not given 

G0921      Documentation of patient reason(s) for not being able to assess (e.g., patient refuse endoscopic and/or radiologic assessment)

G0922      No documentation of disease type, anatomic location, and activity, reason not given

G8400      Patient with central dual-energy x-ray absorptiometry (DXA) results not documented or not ordered or pharmacologic therapy (other than minerals/vitamins) for osteoporosis not prescribed, reason not given 

G8417      Calculated BMI above normal parameters and a follow-up plan was documented

G8418      Calculated BMI below the lower parameter and a follow-up plan was documented 

G8419      Calculated BMI outside normal parameters, no follow-up plan was documented

G8427      Eligible professional to documenting the patient’s current medications to the best of his/her knowledge and ability

G8428      Current medication and route not documented by eligible professional, reason not specified

G8430      Eligible professional attests the patient is not eligible for medication documentation

G8431      Positive screen for clinical depression with a documented follow-up plan

G8432      Clinical depression screening not documented, reason not given

G8433      Screening for clinical depression not documented, patient not eligible/appropriate

G8450       Beta-blocker therapy prescribed

G8452       Beta-blocker therapy not prescribed

G8475       Angiotensin converting enzyme (ACE) ingibitor or angiotensin receptor blocker (ARB) 
therapy not prescribed, reason not given

G8478      Blood pressure measurement not performed or documented, reason not given

G8483      Influenza immunization was not ordered or administered for reasons documented by clinician (e.g., patient allergy or other medical reason, patient declined or other patient reasons, or other system reasons)

G8484     Influenza immunization was not ordered or administered, reason not given

G8485     I intend to report the diabetes mellitus (DM) measure group

G8490     I intent to report the rheumatoid arthritis (RA) measure group

G8494     All quality actions for the applicable measures in the diabetes mellitus (DM) measures 
group have been performed for this patient

G8495      All quality actions for the applicable measure in the chronic kidney disease (CKD) measures group have been performed for this patient

G8499    All quality actions for the applicable measures in the rheumatoid arthritis (RA) measure group have been performed for this patient

G8509    Documentation of positive pain assessment; no documentation of a follow-up plan, reason not given

G8410      Negative screen for clinical depression, follow-up not required

G8451   Positive screen for clinical depression documented, follow up plan not documented, reason not given

G8432     Clinician documented that patient received vascular access other than autogenous AV fistula, reason not given

G8536     No documentation of an elder maltreatment screen, reason not given

G8539     Document of a functional outcome assessment using a standardized tool and documentation of a care plan based on identified deficiencies on the date of the functional outcome assessment

G8541     Functional outcome assessment using a standardized tool, not documented, reason not given

G8542     Documentation of a functional outcome assessment using a standardized tool; no functional deficiencies identified, care plan not required

G8543     Documentation of a functional outcome assessment using a standardized tool; care plan not documented, reason not given

G8558     Not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given

G8563     Patient not referred a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given

G8568     Patient was not referred to a physician (preferable a physician with training in disorders of the ear) for an otologic evaluation, reason not given

G8577     Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason        

G8578      Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason

G8592      No documentation of blood pressure measurement, reason not given

G8594      Lipid profile not performed, reason not given

G8599      Aspirin or another antithrombotic therapy not used, reason not given

G8602       IV tPA not intitiated within 3 hours (<= 180 minutes) of time last known well, reason not given

G8604       Score on the spoken language comprehension functional communication measure at discharge was not higher than at admission, reason not given

G8607       Score on the attention functional communication measure at discharge was not higher than at admission, reason not given

G8610       Score on the memory functional communication measure at discharge was not higher than at admission, reason not given

G8613       Score on the motor speech functional communication measure at discharge was not higher than at admission, reason not given

G8616       Score on the reading functional communication measure at discharge was not higher than at admission, reason not given

G8619       Score on the spoken language expression functional communication measure at discharge was not higher than at admission, reason not given

G8622       Score on the writing functional communication measure at discharge was not higher than at admission, reason not given

G8625        Score on the swallowing functional communication measure at discharge was not higher than at admission, reason not given

G8632        Prophylactic parenteral antibiotics were not ordered to given or given within one hour (if fluoroquinolone or vancomycian, 2 hours) prior to the surgical incision (or start or procedure when no incision is required), reason not given

G8635         Pharmacologic therapy for osteoporosis was not prescribed, reason not given

G8650           Risk-adjusted functional stats change residual scores for the knee not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8654           Risk-adjusted functional status change residual score for the hip not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8658          Risk-adjusted functional status change residual score for the lower leg, foot or ankle not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8662           Risk-adjusted functional status change residual score for the lumber spine not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8666          Risk-adjusted functional status change residual score for the shoulder not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8670          Risk-adjusted functional status change residual score for the elbow, wrist or hand not 
measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8674          Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopedic impairment not measured because the patient did not complete foto’s functional intake on admission and/or follow up status survey near discharge, reason not given

G8682          LVF testing performed during the measurement period

G8683          LVF testing not performed, patient not eligible

G8685          LVF testing not performed, reason not given

G8697          Antithrombotic therapy not prescribed for documented reasons (e.g., patient admitted for performance of elective carotidintervention, patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))

G8698          Antithrombotic therapy was not prescribed at discharge, reason not given

G8707          12-lead electrocardiogram (ECG) not performed, reason not given

G8714        Hemodialysis treatment performed exactly 3 times per weak> 90 days

G8717        SpKt/V less than 1.2 (single-pool clearance of urea [Kt] volume V), reason not given

G8720        Total Kt/V less than 1.7 per weak (total clearance of urea [Kt]/volume V), reason not given                                     

G8722         Medical reason(s) documented for not including pT category, pN category and histology grade in the pathology report (e.g., anal canal)

G8724        PT category, pN category and histology grade were not documented in the pathology report, reason not given

G8726        Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)

G8728        Fasting lipid profile not performed, reason not given

G8732        No documentation of pain assessment, reason not given

G8733        Documentation of a positive elder maltreatment screen and documented follow-up plan at the time of the positive screen

G8735        Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given

G8740        Left ventricular ejection fraction (LVEF) not performed or assessed, reason not given

G8751        Smoking status and exposure to secondhand smoke in the home not assessed, reason not given

G8756        No documentation of blood pressure measurement, reason not given

G8757        All quality actions for the applicable measure in chronic obstructive pulmonary disease (COPD) measures group have been performed for this patient

G8758        All quality action for the applicable measure in the inflammatory bowel disease (IBD) measures group have been performed for this patient

G8759        All quality action for the applicable measures in the sleep apnea measure group have been performed for this patient

G8763        All quality action for the applicable measures in the hypertension (HTN) measures group have been performed for this patient

G8769          Lipid profile not performed, reason not given

G8773          Urine protein test was not performed, reason not given

G8776           Serum creatinine test not performed, reason not given

G8779           Diabetes screening test not performed, reason not given

G8782          Counseling for diet and physical activity not performed, reason not given

G8783          Normal blood pressure reading documented, follow-up not required

G8784          Blood pressure not documented, patient not eligible/not appropriate

G8785          Blood pressure reading not documented, reason not given

G8796          Blood pressure measurement not documented, reason not given

G8801          Anticoagulation was not ordered, reason not given

G8807         Transabdominal or transvaginal ultrasound not performed for reason documented by clinician (e.g., patient was visited the ED multiple times within 72 hours, patient has a documented intrauterine pregnancy (IUP)

G8808         Performance of tansabdominal or transvaginal ultrasound not ordered, reason not given

G8810          Rh-immunoglobulin (RhoGam) not order for reason documented by clinician (e.g., patient had prior documented receipt of RhoGram within 12 weaks)

G8811          Documentation Rh immunoglobulin (Rhogam) was not ordered, reason not specified

G8812          Patient is not eligible for follow-up CTA, duplex, or MRA (e.g., patient death, failure to return for scheduled follow-up study which will meet numerator criteria has yet occurred at the time of reporting)

G8815           Statin therapy not prescribed for documented reason (e.g., medical intolerance to statin, death of patient prior to discharge, transfer to care of another acuter acute care or federal hospital, hospice admission, left against medical advice)

G8817           Statin therapy not prescribed at discharge, reason not given

G8838          patient not discharged to home by postoperative day #2 following CEA

G8841          Sleep apnea symptoms not assessed, reason not given

G8843          Documentation of reason(s) for not measuring an apnea hypopnea index (AHI) or a respiratory disturbance index (RDI) at the time of initial diagnosis (e.g., abnormal anatomy, patient declined, financial, insurance coverage)

G8844          apnea hypopna index (AHI) or respiratory disturbance index (RDI) not measured at the time of initial diagnosis, reason not given

G8849          Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)

G8850         Positive airway pressure therapy not prescribed, reason not given

G8854          Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient did not bring data from continuous positive airway pressure (CPAP), therapy not yet initiated, not available on machine)

G8855          Objective measurement of adherence to positive airway pressure therapy not performed, reason not given

G8858          Referral to physician for an otologic evaluation not performed, reason not given

G8863          Patient not assessed for risk of bone loss, reason not given

G8867          Pneumococcal vaccine not administered or previously received, reason not given

G8873          Patient with needle localization specimens which are not amenable to intraoperative imaging such as MRI needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)

G8876          Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., clinical and imaging finding consistent with a benign lesion, lesion too close to skin, implant, chest well, etc., lesion could not be adequately visualized for needle bioipsy, patient condition prevents needle biopsy weight, breast thickness, etc.,) duct excision without imaging abnormally, prophylactic mastectomy, reductionmammoplasty, excisional biopsy performed by another physician

G8877         Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given

G8880          Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., cancer diagnosed at prophylactic mastectomy, non-invasive cancer, incidental discovery of breast cancer on reduction mammoplasty, biopsy proven lymph node (in) metasteses (e.g., preop FNA or core biopsy, inflammatory carcinoma, recurrent invasive breast cancer patient refusal after informed consent)

G8887          Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patient who had a terminal illness or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)

G8889          No documentation of blood pressure measurement, reason not given

G8894          LDL-C not performed, reason not given

G8895          Oral aspirin or other antithrombotic therapy prescribed

G8896          Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)

G8897         Oral aspirin or other antithrombotic therapy was not prescribed, reason not given

G8898         I intend to report the chronic obstructive pulmonary disease (COPD) measures group

G8899        I intend to report the inflammatory bowel disease (IBD) measures group

G8900        I intend to report the sleep apnea measures group

G8904        I intend to report the hypertension (HTN) measures group

G8907        Patient documented not to have experienced any of the following events; a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility

G8908        Patient documented to have received a burn prior to discharge

G8909        Patient documented not to have received a burn prior to discharge

G8910        Patient documented to have experienced a fall within ASC

G8911        Patient documented not to have experience a fall within ambulatory surgery center

G8912         Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong 
procedure or wrong implant event

G8913         Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event

G8914        Patient documented to have experienced a hospital transfer or hospital admission upon discharge from ASC

G8915         Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from ASC

G8916         Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic initiated on time

G8917         Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic not initiated on time

G8918         Patient within preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis

G9005         Coordinated care fee risk adjusted maintenance

G9008         Coordinated care fee, physician coordinated care oversight services

G9009         Coordinated care fee, risk adjusted maintenance, level 3

G9010         Coordinated care fee, risk adjusted maintenance, level 4

J1569           Injection, immune globulin, (Gammagard liquid), nonlyophilzed, (e.g., liquid), 500 mg

J7196           Injection, antithrombin recombinant, 50 IU

J9020           Injection, asparaginase, not otherwise specified, 10.000 units

J9280           Injection, mitomycin, 5 mg

L5972           All lower extremity prostheses, foot, flexible keel

L8000           Breast prosthesis, mastectomy bra, without integrated breast prosthesis from, any size, any type

L8001           Breast prosthesis, mastectomy bra, with integrated breast prosthesis from, unilateral, any size, any type

L8002         Breast prosthesis, mastectomy bra, with integrated breast prosthesis from, bilateral, any size, any type

P9603         Travel allowance, one way in connection with medically necessary laboratory specimen collection drawn from homebound or nursing homebound patient; prorated miles actually travelled

Q4119         MatriStem Wound Matrix, PSMX, RS, or PSM, per sq cm

Q4126         MemoDerm, DermaSpan, TranZgraft or InteguPly, per sq cm

Q4128        FlexHD, AllopatchHD, or Matrix HD, per sq cm

V5267        Hearing aid or assistive listening device/supplies/accessories, not otherwise specified 
 

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