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

  • G8892

    Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)

  • G8893

    Most recent ldl-c not under control, results documented and reviewed

  • 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

  • G8902

    I intend to report the dementia measures group

  • G8903

    I intend to report the parkinson's disease measures group

  • G8904

    I intend to report the hypertension (htn) measures group

  • G8905

    I intend to report the cardiovascular prevention measures group

  • G8906

    I intend to report the cataract 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 experienced a fall within ambulatory surgical 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 without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis

  • G8923

    Current or prior left ventricular ejection fraction (lvef) <= 40% or documentation of moderately or severely depressed left ventricular systolic function

  • G8924

    Spirometry results documented (fev1/fvc < 70%)

  • G8925

    Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms

  • G8926

    Spirometry test not performed or documented, reason not given

  • G8927

    Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer

  • G8928

    Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)

  • G8929

    Adjuvant chemotherapy not prescribed or previously received, reason not given

  • G8930

    Assessment of depression severity at the initial evaluation

  • G8931

    Assessment of depression severity not documented, reason not given

  • G8932

    Suicide risk assessed at the initial evaluation

  • G8933

    Suicide risk not assessed at the initial evaluation, reason not given

  • G8934

    Current or prior left ventricular ejection fraction (lvef) <=40% or documentation of moderately or severely depressed left ventricular systolic function

  • G8935

    Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy

  • G8936

    Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons)

  • G8937

    Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given

  • G8938

    Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible

  • G8939

    Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter

  • G8940

    Screening for depression documented as positive, a follow-up plan not completed, documented reason

  • G8941

    Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter

  • G8942

    Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment

  • G8943

    Ldl-c result not present or not within 12 months prior

  • G8944

    Ajcc melanoma cancer stage 0 through iic melanoma

  • G8946

    Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)

  • G8947

    One or more neuropsychiatric symptoms