Codify By AAPC
HCPCS Range Additional Quality Measures
1
Left ventricular ejection fraction (LVEF) >= 40% or documentation as normal or mildly depressed left ventricular systolic function ( G8395 )
2
Left ventricular ejection fraction (LVEF) not performed or documented ( G8396 )
3
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy ( G8397 )
4
Patient with documented results of a central dual-energy X-ray absorptiometry (DXA) ever being performed ( G8399 )
5
Patient with central dual-energy X-ray absorptiometry (DXA) results not documented, reason not given ( G8400 )
6
Lower extremity neurological exam performed and documented ( G8404 )
7
Lower extremity neurological exam not performed ( G8405 )
8
Footwear evaluation performed and documented ( G8410 )
9
Footwear evaluation was not performed ( G8415 )
10
Clinician documented that patient was not an eligible candidate for footwear evaluation measure ( G8416 )
11
BMI is documented above normal parameters and a follow-up plan is documented ( G8417 )
12
BMI is documented below normal parameters and a follow-up plan is documented ( G8418 )
13
BMI documented outside normal parameters, no follow-up plan documented, no reason given ( G8419 )
14
BMI is documented within normal parameters and no follow-up plan is required ( G8420 )
15
BMI not documented and no reason is given ( G8421 )
16
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given ( G8428 )
17
Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an urgent or emergent medical situation) ( G8430 )
18
Screening for depression is documented as being positive and a follow-up plan is documented ( G8431 )
19
Depression screening not documented, reason not given ( G8432 )
20
Screening for depression not completed, documented patient or medical reason ( G8433 )
21
Beta-blocker therapy prescribed ( G8450 )
22
Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons) ( G8451 )
23
Beta-blocker therapy not prescribed ( G8452 )
24
High or very high risk of recurrence of prostate cancer ( G8465 )
25
Most recent blood pressure has a systolic measurement of < 140 mmHg and a diastolic measurement of < 90 mmHg ( G8476 )
26
Most recent blood pressure has a systolic measurement of >=140 mmHg and/or a diastolic measurement of >=90 mmHg ( G8477 )
27
Blood pressure measurement not performed or documented, reason not given ( G8478 )
28
Influenza immunization administered or previously received ( G8482 )
29
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) ( G8483 )
30
Influenza immunization was not administered, reason not given ( G8484 )
31
Screening for depression is documented as negative, a follow-up plan is not required ( G8510 )
32
Screening for depression documented as positive, follow-up plan not documented, reason not given ( G8511 )
33
No documentation of an elder maltreatment screen, reason not given ( G8536 )
34
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment ( G8539 )
35
Functional outcome assessment using a standardized tool not documented, reason not given ( G8541 )
36
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required ( G8542 )
37
Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given ( G8543 )
38
Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation ( G8559 )
39
Patient has a history of active drainage from the ear within the previous 90 days ( G8560 )
40
Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure ( G8561 )
41
Patient does not have a history of active drainage from the ear within the previous 90 days ( G8562 )
42
Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given ( G8563 )
43
Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified) ( G8564 )
44
Verification and documentation of sudden or rapidly progressive hearing loss ( G8565 )
45
Patient is not eligible for the "referral for otologic evaluation for sudden or rapidly progressive hearing loss" measure ( G8566 )
46
Patient does not have verification and documentation of sudden or rapidly progressive hearing loss ( G8567 )
47
Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given ( G8568 )
48
Prolonged postoperative intubation (> 24 hrs) required ( G8569 )
49
Prolonged postoperative intubation (> 24 hrs) not required ( G8570 )
50
Developed postoperative renal failure or required dialysis ( G8575 )
51
No postoperative renal failure/dialysis not required ( G8576 )
52
Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason ( G8577 )
53
Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason ( G8578 )
54
Aspirin or another antiplatelet therapy used ( G8598 )
55
Aspirin or another antiplatelet therapy not used, reason not given ( G8599 )
56
Iv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well ( G8600 )
57
Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention) ( G8601 )
58
Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well, reason not given ( G8602 )
59
Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed ( G8633 )
60
Pharmacologic therapy for osteoporosis was not prescribed, reason not given ( G8635 )
61
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications ( G8427 )
62
Angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy prescribed ( G8473 )
63
Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) ( G8474 )
64
Angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy not prescribed, reason not given ( G8475 )
65
Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter related to one of the following reasons: (1) patient refuses to participate in the screening and has reasonable decisional capacity for self-protection, or (2) patient is in an urgent or emergent situation where time is of the essence and to delay treatment to perform the screening would jeopardize the patient's health status ( G8535 )
66
Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter ( G8540 )