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

  • G9300

    Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)

  • G9301

    Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet

  • G9302

    Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given

  • G9303

    Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given

  • G9304

    Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant

  • G9305

    Intervention for presence of leak of endoluminal contents through an anastomosis not required

  • G9306

    Intervention for presence of leak of endoluminal contents through an anastomosis required

  • G9307

    No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure

  • G9308

    Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure

  • G9309

    No unplanned hospital readmission within 30 days of principal procedure

  • G9310

    Unplanned hospital readmission within 30 days of principal procedure

  • G9311

    No surgical site infection

  • G9312

    Surgical site infection

  • G9313

    Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason

  • G9314

    Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given

  • G9315

    Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis

  • G9316

    Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family

  • G9317

    Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed

  • G9318

    Imaging study named according to standardized nomenclature

  • G9319

    Imaging study not named according to standardized nomenclature, reason not given

  • G9320

    Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9321

    Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion or infarct avid imaging) studies documented in the 12-month period prior to the current study

  • G9322

    Count of previous ct and cardiac nuclear medicine (myocardial perfusion or infarct avid imaging) studies not documented in the 12-month period prior to the current study, reason not given

  • G9323

    Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9324

    All necessary data elements not included, reason not given

  • G9325

    Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9326

    Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given

  • G9327

    Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements

  • G9328

    Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9329

    Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given

  • G9340

    Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study

  • G9341

    Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed

  • G9342

    Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given

  • G9343

    Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9344

    Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)

  • G9345

    Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors

  • G9346

    Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)

  • G9347

    Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given

  • G9348

    Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons

  • G9349

    Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis

  • G9350

    Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis

  • G9351

    More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis

  • G9352

    More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given

  • G9353

    More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)

  • G9354

    One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis

  • G9355

    Elective delivery (without medical indication) by cesarean birth or induction of labor not performed (<39 weeks of gestation)

  • G9356

    Elective delivery (without medical indication) by cesarean birth or induction of labor performed (<39 weeks of gestation)

  • G9357

    Post-partum screenings, evaluations and education performed

  • G9358

    Post-partum screenings, evaluations and education not performed

  • G9359

    Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier