Showing codes G2159 (Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period) — G2189 (Patients with clinical indications for imaging of the head: abnormal neurologic exam)

G2159 - No pneum vacc 12 mo 60+
Long description: Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2160 - Herpzos 50+
Long description: Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2161 - Adv rx zos
Long description: Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2162 - No herpzos 50+
Long description: Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2163 - Infl vacc 07/01 to 06/30
Long description: Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2164 - Adv rx infl vacc
Long description: Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2165 - No infl vacc 07/01 to 06/30
Long description: Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2166 - No pt adm dx no neck fs prom
Long description: Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2167 - Res change sc < 0
Long description: Residual score for the neck impairment successfully calculated and the score was less than zero (< 0)
Code added date: 20200101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2168 - Svs by pt in home health
Long description: Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes
Code added date: 20200101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2169 - Svs by ot in home health
Long description: Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
Code added date: 20200101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2170 - Avf by tissue w thermal e
Long description: Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed
Code added date: 20200701.
Code effective date: 20230101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2171 - Avf use magnetic/art/ven
Long description: Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed
Code added date: 20200701.
Code effective date: 20230101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2172 - Tx for opioid use demo proj
Long description: All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project
Code added date: 20210401.
Code effective date: 20210401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2173 - Uri w comorb 12m oth dx
Long description: Uri episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)
Code added date: 20210101.
Code effective date: 20220101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2174 - Uri new rx antibiotic 30d
Long description: Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
Code added date: 20210101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2175 - Pt comorb dx 12m of epi
Long description: Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)
Code added date: 20210101.
Code effective date: 20220101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2176 - Outpt ed obs w inpt admit
Long description: Outpatient, ed, or observation visits that result in an inpatient admission
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2177 - Bronch w rx antibx 30d
Long description: Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date
Code added date: 20210101.
Code effective date: 20220101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2178 - Pt not elig low neuro ex
Long description: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, alzheimer's, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2179 - Med doc rsn no low ex
Long description: Clinician documented that patient had medical reason for not performing lower extremity neurological exam
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2180 - Inelig footwr eval
Long description: Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2181 - Bmi not doc medrsn ptref
Long description: Bmi not documented due to medical reason or patient refusal of height or weight measurement
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2182 - Pt 1st biolog antirheum
Long description: Patient receiving first-time biologic and/or immune response modifier therapy
Code added date: 20210101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2183 - Doc pt unable comm
Long description: Documentation patient unable to communicate and informant not available
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2184 - No caregiver
Long description: Patient does not have a caregiver
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2185 - Caregiver dem trained
Long description: Documentation caregiver is trained and certified in dementia care
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2186 - Pt ref app rsrcs
Long description: Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2187 - Clin ind img hd trauma
Long description: Patients with clinical indications for imaging of the head: head trauma
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2188 - Pt 50 yrs w/clin ind hd
Long description: Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G2189 - Img hd abnml neuro exam
Long description: Patients with clinical indications for imaging of the head: abnormal neurologic exam
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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