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

  • G9211

    Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given

  • G9212

    Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation

  • G9213

    Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified

  • G9214

    Cd4+ cell count or cd4+ cell percentage results documented

  • G9215

    Cd4+ cell count or percentage not documented as performed, reason not given

  • G9216

    Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given

  • G9217

    Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given

  • G9218

    Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given

  • G9219

    Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

  • G9220

    Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

  • G9221

    Pneumocystis jiroveci pneumonia prophlaxis prescribed

  • G9222

    Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3

  • G9223

    Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%

  • G9224

    Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)

  • G9225

    Foot exam was not performed, reason not given

  • G9226

    Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)

  • G9227

    Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter

  • G9228

    Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)

  • G9229

    Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)

  • G9230

    Chlamydia, gonorrhea, and syphilis not screened, reason not given

  • G9231

    Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period

  • G9232

    Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)

  • G9233

    All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient

  • G9234

    I intend to report the total knee replacement measures group

  • G9235

    All quality actions for the applicable measures in the general surgery measures group have been performed for this patient

  • G9236

    All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient

  • G9237

    I intend to report the general surgery measures group

  • G9238

    I intend to report the optimizing patient exposure to ionizing radiation measures group

  • G9239

    Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)

  • G9240

    Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated

  • G9241

    Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated

  • G9242

    Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed

  • G9243

    Documentation of viral load less than 200 copies/ml

  • G9244

    Antiretroviral thereapy not prescribed

  • G9245

    Antiretroviral therapy prescribed

  • G9246

    Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

  • G9247

    Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart

  • G9248

    Patient did not have a medical visit in the last 6 months

  • G9249

    Patient had a medical visit in the last 6 months

  • 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