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

  • 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)

  • G9430

    Specimen site other than anatomic cutaneous location

  • G9431

    Pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors

  • G9432

    Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented

  • G9433

    Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period

  • G9434

    Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given

  • G9435

    Aspirin prescribed at discharge

  • G9436

    Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)

  • G9437

    Aspirin not prescribed at discharge

  • G9438

    P2y inhibitor prescribed at discharge

  • G9439

    P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)

  • G9440

    P2y inhibitor not prescribed at discharge

  • G9441

    Statin prescribed at discharge

  • G9442

    Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)

  • G9443

    Statin not prescribed at discharge

  • G9448

    Patients who were born in the years 1945 to 1965

  • G9449

    History of receiving blood transfusions prior to 1992

  • G9450

    History of injection drug use

  • G9451

    Patient received one-time screening for hcv infection

  • G9452

    Documentation of medical reason(s) for not receiving hcv antibody test due to limited life expectancy

  • G9453

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

  • G9454

    One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given

  • G9455

    Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc

  • G9456

    Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)

  • G9457

    Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period

  • G9458

    Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user

  • G9459

    Currently a tobacco non-user

  • G9460

    Tobacco assessment or tobacco cessation intervention not performed, reason not given

  • G9463

    I intend to report the sinusitis measures group

  • G9464

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

  • G9465

    I intend to report the acute otitis externa (aoe) measures group

  • G9466

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

  • G9467

    Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months

  • G9468

    Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills

  • G9469

    Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills

  • G9470

    Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills

  • G9471

    Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented

  • G9472

    Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed

  • G9473

    Services performed by chaplain in the hospice setting, each 15 minutes

  • G9474

    Services performed by dietary counselor in the hospice setting, each 15 minutes