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

  • G9376

    Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery

  • G9377

    Patient did not have the retina attached after 6 months following only one surgery

  • G9378

    Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)

  • G9379

    Patient did not achieve flat retinas six months post surgery

  • G9380

    Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period

  • G9381

    Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period

  • G9382

    Patient not offered assistance with end of life issues or existing end of life plan was not reviewed or updated during the measurement period

  • G9383

    Patient received screening for hcv infection within the 12 month reporting period

  • G9384

    Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)

  • G9385

    Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)

  • G9386

    Screening for hcv infection not received within the 12 month reporting period, reason not given

  • G9389

    Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery

  • G9390

    No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery

  • G9391

    Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit

  • G9392

    Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit

  • G9393

    Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five

  • G9394

    Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period

  • G9395

    Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five

  • G9396

    Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)

  • G9399

    Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment

  • G9400

    Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons

  • G9401

    No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment

  • G9402

    Patient received follow-up within 30 days after discharge

  • G9403

    Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)

  • G9404

    Patient did not receive follow-up within 30 days after discharge

  • G9405

    Patient received follow-up within 7 days after discharge

  • G9406

    Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)

  • G9407

    Patient did not receive follow-up within 7 days after discharge

  • G9408

    Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days

  • G9409

    Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days

  • G9410

    Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

  • G9411

    Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

  • G9412

    Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

  • G9413

    Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

  • G9414

    Patient had one dose of meningococcal vaccine (serogroups a, c, w, y or a, c, w, y, b) on or between the patient's 10th and 13th birthdays

  • G9415

    Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y or a, c, w, y, b), on or between the patient's 10th and 13th birthdays

  • G9416

    Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays

  • G9417

    Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays

  • G9418

    Primary non-small cell lung cancer lung biopsy and cytology specimen report documents classification into specific histologic type following iaslc guidance or classified as nsclc-nos with an explanation

  • G9419

    Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g. specimen insufficient or non-diagnostic, specimen does not contain cancer, or other documented medical reasons)

  • G9420

    Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer

  • G9421

    Primary non-small cell lung cancer lung biopsy and cytology specimen report does not document classification into specific histologic type or histologic type does not follow iaslc guidance or is classified as nsclc-nos but without an explanation

  • G9422

    Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma and not nsclc-nos)

  • G9423

    Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]

  • G9424

    Specimen site other than anatomic location of lung, or classified as nsclc-nos

  • G9425

    Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma)

  • G9426

    Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients

  • G9427

    Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients

  • G9428

    Pathology report includes the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors

  • G9429

    Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons)