| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99233 |
Prolong inpt eval add15 m |
46,754 |
15,201 |
$2.14M |
| 99310 |
Prolong nursin fac eval 15m |
65,088 |
25,364 |
$1.90M |
| 99223 |
Prolong inpt eval add15 m |
11,938 |
10,476 |
$895K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
30,527 |
16,401 |
$595K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
9,258 |
8,074 |
$434K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
10,121 |
3,799 |
$368K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,483 |
767 |
$225K |
| 99306 |
Prolong nursin fac eval 15m |
5,086 |
3,835 |
$152K |
| 99222 |
Initial hospital care, per day, moderate complexity |
2,225 |
2,120 |
$147K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
3,583 |
2,384 |
$52K |
| 99497 |
|
9,011 |
5,472 |
$48K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,098 |
1,018 |
$40K |
| 99220 |
|
517 |
441 |
$17K |
| 99221 |
|
233 |
203 |
$11K |
| 99316 |
|
1,272 |
1,030 |
$8K |
| 99490 |
Ccm add 20min |
1,131 |
901 |
$6K |
| 99305 |
|
178 |
162 |
$6K |
| 99418 |
Prolong nursin fac eval 15m |
60 |
46 |
$5K |
| 99307 |
|
320 |
236 |
$5K |
| 99217 |
|
291 |
222 |
$2K |
| G0317 |
Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes) |
462 |
368 |
$413.01 |
| 99304 |
|
22 |
17 |
$380.92 |
| G0316 |
Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) |
129 |
87 |
$380.42 |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
279 |
195 |
$51.59 |
| 99406 |
|
425 |
273 |
$44.00 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
136 |
95 |
$0.00 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
721 |
377 |
$0.00 |
| 1123F |
|
24,582 |
10,457 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,066 |
773 |
$0.00 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
344 |
252 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
18,694 |
7,331 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
14,130 |
5,768 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
20,702 |
9,097 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
3,241 |
1,399 |
$0.00 |
| G8923 |
Current or prior left ventricular ejection fraction (lvef) <= 40% or documentation of moderately or severely depressed left ventricular systolic function |
15 |
13 |
$0.00 |
| 4086F |
|
3,998 |
1,510 |
$0.00 |
| 1101F |
|
13,059 |
6,107 |
$0.00 |
| G8967 |
Fda approved oral anticoagulant is prescribed |
4,428 |
1,501 |
$0.00 |
| G9707 |
Patient received hospice services any time during the measurement period |
38 |
26 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
174 |
105 |
$0.00 |
| 3044F |
|
1,731 |
742 |
$0.00 |
| G9512 |
Individual had a pdc of 0.8 or greater |
35 |
29 |
$0.00 |
| G2181 |
Bmi not documented due to medical reason or patient refusal of height or weight measurement |
32 |
23 |
$0.00 |
| 1100F |
|
8,050 |
3,702 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
47,132 |
18,071 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
37,587 |
19,409 |
$0.00 |
| 4040F |
|
20,948 |
8,913 |
$0.00 |
| 1124F |
|
3,348 |
2,001 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
1,299 |
726 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
10,206 |
4,328 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
21,698 |
8,362 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
24,376 |
8,680 |
$0.00 |
| 3046F |
|
3,134 |
1,178 |
$0.00 |
| 0518F |
|
6,764 |
3,054 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,523 |
1,005 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
172 |
107 |
$0.00 |
| G9928 |
Fda-approved anticoagulant not prescribed, reason not given |
575 |
275 |
$0.00 |
| 3288F |
|
8,126 |
3,733 |
$0.00 |
| G9513 |
Individual did not have a pdc of 0.8 or greater |
997 |
505 |
$0.00 |
| G9996 |
Documentation stating the patient has received or is currently receiving palliative or hospice care |
89 |
43 |
$0.00 |
| G9990 |
Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
974 |
374 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
19 |
19 |
$0.00 |
| G9718 |
Hospice services for patient provided any time during the measurement period |
16 |
14 |
$0.00 |
| G9692 |
Hospice services received by patient any time during the measurement period |
35 |
26 |
$0.00 |
| 3045F |
|
92 |
32 |
$0.00 |
| G9991 |
Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
23 |
12 |
$0.00 |