HCPCS Codes Explained
Healthcare Common Procedure Coding System codes for medical procedures and services. Understand what each code means on your medical bills.
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Showing 50 of 123 HCPCS codes
G8754Documentation that your most recent diastolic blood pressure reading was less than 90 mmHg
This code is used to document that your most recent diastolic blood pressure (the bottom number in a blood pressure reading) was measured at less than 90 mmHg. The diastolic pressure represents the pressure in your arteries when your heart is resting between beats. A diastolic reading below 90 mmHg is generally considered within normal to optimal range for blood pressure control.
A9579Gadolinium-based contrast dye injection for MRI scan (1 ml)
This code represents one milliliter of a gadolinium-based contrast agent that is injected into your body during an MRI (magnetic resonance imaging) scan. Gadolinium is a safe contrast material that helps make certain body parts, blood vessels, or abnormal tissues show up more clearly on MRI images. The 'not otherwise specified' means this covers gadolinium contrast agents that don't fall into other specific categories. The contrast dye is typically given through an IV line in your arm before or during the MRI procedure.
G8752Documentation that your most recent systolic blood pressure reading was less than 140 mmHg
This code is used to document that your most recent systolic blood pressure measurement was below 140 mmHg. Systolic blood pressure is the top number in a blood pressure reading and represents the pressure in your arteries when your heart beats. A reading below 140 mmHg for the systolic pressure is generally considered within acceptable ranges for blood pressure control.
G0476HPV DNA test for high-risk cancer-causing types (combined with Pap test)
This is a laboratory test that looks for the genetic material (DNA or RNA) of high-risk human papillomavirus (HPV) types that can cause cervical cancer. The test specifically checks for HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. This test must be done together with a Pap test as part of cervical cancer screening. The combination of both tests provides more comprehensive screening than either test alone.
G8950Documentation of elevated or high blood pressure with follow-up plan recorded
This code is used when a healthcare provider has documented that a patient had an elevated or high blood pressure reading during a visit, and the provider has also documented what follow-up care or monitoring is recommended. This ensures that both the blood pressure concern and the plan for addressing it are properly recorded in the medical record.
G0145Automated cervical or vaginal cancer screening test with thin-layer preparation and manual review
This is a cervical or vaginal cancer screening test (like a Pap smear) where cells are collected and preserved in a special fluid. The sample is prepared using an automated thin-layer technique, then screened by an automated computer system. After the automated screening, a trained technician manually reviews the results under physician supervision to ensure accuracy. This type of screening helps detect abnormal cells that could indicate cervical or vaginal cancer or pre-cancerous conditions.
J2543Injectable antibiotic medication (piperacillin/tazobactam) given through IV or injection
This code represents a specific dose of piperacillin/tazobactam, which is a combination antibiotic medication given by injection or intravenous (IV) infusion. The code covers 1.125 grams total (1 gram of piperacillin sodium plus 0.125 grams of tazobactam sodium). This antibiotic combination is used to treat various bacterial infections by stopping bacteria from growing and making the antibiotic more effective against certain resistant bacteria.
G8420Documentation that BMI (Body Mass Index) is within normal range with no follow-up needed
This code indicates that your Body Mass Index (BMI) has been calculated and documented as being within normal, healthy parameters. BMI is a measurement that uses your height and weight to assess if you're in a healthy weight range. Since your BMI is normal, your healthcare provider has determined that no additional follow-up plan or intervention is required at this time.
J70605% dextrose in water solution (500 ml)
This code represents a 500 milliliter bag or bottle of 5% dextrose in water solution. Dextrose is a form of sugar (glucose) mixed with sterile water. This intravenous (IV) fluid is commonly used in hospitals and medical facilities to provide hydration and a source of calories. The solution contains 5 grams of dextrose per 100 milliliters of water. One unit equals 500 ml of this solution.
G8427Documentation that your doctor reviewed your current medications
This code indicates that an eligible healthcare provider has documented in your medical record that they obtained, updated, or reviewed your current list of medications. This is an important safety measure to ensure your doctor has accurate, up-to-date information about all the medications you are taking, including prescription drugs, over-the-counter medications, and supplements.
G0101Cancer screening exam including pelvic exam and clinical breast exam
This code represents a preventive care visit that includes screening for cervical or vaginal cancer through a pelvic examination, combined with a clinical breast examination performed by a healthcare provider. During the pelvic exam, the doctor examines the reproductive organs to check for signs of cancer or other abnormalities. The clinical breast exam involves the healthcare provider physically examining the breasts and surrounding areas to feel for lumps or other changes that might indicate cancer.
G8510Documentation that depression screening was negative and no follow-up plan is needed
This code is used by healthcare providers to document that a patient was screened for depression and the results were negative (meaning no signs of depression were found). Because the screening was negative, no follow-up treatment plan or additional monitoring for depression is required at this time. This is a documentation code that helps track that proper depression screening was performed and the results.
G0333Pharmacy dispensing fee for inhaled medications (first 30-day supply)
This code represents the fee charged by a pharmacy for dispensing inhaled medications for the initial 30-day supply. This is specifically the service fee for preparing and providing the medication, separate from the cost of the medication itself. It applies to medications that are inhaled, such as those used for asthma, COPD, or other respiratory conditions.
G02793D mammography imaging (breast tomosynthesis)
This code represents diagnostic digital breast tomosynthesis, which is a specialized type of 3D mammography. It creates detailed, layered images of breast tissue that can be viewed slice by slice, similar to a CT scan but specifically for breast imaging. This procedure can be performed on one breast (unilateral) or both breasts (bilateral) and is used in addition to standard mammography to get clearer, more detailed images of breast tissue. The 3D imaging helps radiologists see through overlapping tissue layers that might obscure abnormalities in traditional 2D mammograms.
A0427Emergency ambulance service with advanced life support, level 1
This code represents emergency ambulance transportation with advanced life support (ALS) level 1 care. ALS level 1 includes basic emergency medical services plus at least one advanced life support procedure or medication administered by qualified emergency medical personnel. This is used for emergency situations requiring immediate medical transport with enhanced care beyond basic ambulance services.
G0382Level 3 emergency department visit at a Type B emergency department
This code represents a moderate complexity emergency department visit (Level 3) that takes place in a Type B emergency department. A Type B emergency department is a facility that meets specific requirements: it must be either licensed by the state as an emergency room/department, publicly advertised as providing urgent emergency care without appointments, or provide at least one-third of its outpatient visits for emergency conditions without requiring scheduled appointments. Level 3 visits typically involve moderately complex medical decision-making and evaluation of patients with urgent but not immediately life-threatening conditions.
Q0091Collection and preparation of a Pap smear for cervical cancer screening
This code covers the healthcare provider's work to collect a sample of cells from your cervix or vagina using a small brush or spatula during a pelvic exam. The provider then prepares this sample and sends it to a laboratory for analysis to screen for cervical cancer and precancerous changes. This is the collection and handling portion of a Pap smear test, which is separate from the actual laboratory analysis of the sample.
J7613Albuterol breathing medication, non-compounded, 1 mg unit dose
This code represents a 1 mg unit dose of albuterol inhalation solution that is FDA-approved and non-compounded (not custom-mixed). Albuterol is a bronchodilator medication that helps open airways in the lungs, making it easier to breathe. This specific form is administered through durable medical equipment (DME) such as a nebulizer machine. Each unit dose contains 1 mg of albuterol in a pre-measured solution ready for inhalation treatment.
G2211Additional billing code for complex medical visits that require extra time and coordination
This is an add-on code that healthcare providers use when your medical visit involves complex care coordination or management of serious or complicated health conditions. It's used alongside the main visit code when your appointment requires significantly more time, thought, or coordination than a typical visit. This might apply when you have multiple serious health issues that need careful management, or when your care requires coordination with other healthcare providers or specialists. The code recognizes that some patients need more intensive evaluation and management during their visits.
V2787Astigmatism correction feature in an artificial lens implanted in the eye
This code represents a special function built into an intraocular lens (IOL) that corrects astigmatism. An intraocular lens is an artificial lens that replaces your eye's natural lens, typically during cataract surgery. When this lens includes astigmatism-correcting capabilities, it can help reduce or eliminate the blurred or distorted vision caused by astigmatism, potentially reducing your need for glasses or contact lenses after surgery.
A7030Full face mask for CPAP machine
This code covers a full face mask that is used with a CPAP (Continuous Positive Airway Pressure) machine or other positive airway pressure device. The mask covers both the nose and mouth, creating a seal to deliver pressurized air to help keep airways open during sleep. This is typically prescribed for patients with sleep apnea or other breathing disorders.
A9270Non-covered item or service
This code indicates that a particular medical item or service is not covered by your insurance plan or Medicare/Medicaid. When this code appears on your medical bill or claim, it means the insurance company has determined that the specific treatment, procedure, equipment, or service does not qualify for coverage under your current benefits. You may be responsible for paying the full cost of this item or service out-of-pocket.
P9604Travel fee for one-way trip to collect lab samples from homebound patients
This code represents a travel allowance fee that covers the cost of a healthcare worker making a one-way trip to collect laboratory specimens from patients who are confined to their home or nursing home. The fee is prorated, meaning it's calculated based on the actual distance or time required for the trip. This service is only used when the lab sample collection is medically necessary and the patient cannot travel to a medical facility.
G0444Annual depression screening visit lasting 5-15 minutes
This code represents a yearly screening appointment specifically designed to check for signs of depression. During this 5 to 15 minute visit, a healthcare provider will ask you questions or have you complete a questionnaire to assess your mental health and identify any symptoms of depression. This is a preventive care service meant to catch depression early, even if you haven't reported feeling depressed.
J0696Ceftriaxone sodium antibiotic injection, billed per 250 mg dose
This code represents billing for ceftriaxone sodium, a powerful antibiotic medication given by injection (either into a vein or muscle). The code covers each 250 mg portion of the medication administered. Ceftriaxone is a broad-spectrum antibiotic used to treat various bacterial infections. This is specifically the billing code for the medication itself, not the administration procedure.
Q5001Hospice or home health care services provided in your home or residence
This code represents hospice care or home health services that are delivered directly in your home or place of residence. This allows you to receive professional medical care, comfort care, or end-of-life services in the familiar environment of your own home rather than in a hospital or facility setting.
G0121Colonoscopy screening for colon cancer in average-risk individuals
This code represents a colonoscopy procedure performed specifically to screen for colorectal (colon and rectal) cancer in individuals who are considered average risk. This means the patient does not have factors that would classify them as high risk for developing colorectal cancer, such as a strong family history, personal history of polyps or inflammatory bowel disease, or certain genetic conditions. The colonoscopy is done as a preventive measure to detect cancer or precancerous changes early, when treatment is most effective.
G8783Documentation of normal blood pressure reading with no follow-up needed
This code is used when a healthcare provider documents that a patient's blood pressure reading was normal and within healthy ranges, and therefore no additional follow-up appointments or monitoring are required at this time. This represents a positive health outcome where the blood pressure screening showed results that don't require further medical attention or intervention.
C9803COVID-19 specimen collection at hospital outpatient clinic
This code represents the collection of a specimen (such as a nasal swab, saliva, or other sample) for COVID-19 testing at a hospital outpatient clinic. The specimen is collected to test for SARS-CoV-2, the virus that causes COVID-19. This code covers the collection process itself, regardless of what type of specimen is collected.
J2270Morphine sulfate injection for pain management (up to 10 mg dose)
This code represents a medical injection of morphine sulfate, a strong pain medication, given in doses up to 10 milligrams. Morphine sulfate is an opioid medication used to treat moderate to severe pain. The injection is administered by healthcare professionals, typically in hospitals, clinics, or other medical facilities. This specific code covers the medication itself when given as an injection, not the administration procedure.
G0442Annual alcohol screening appointment (5-15 minutes)
This code represents an annual screening appointment to assess alcohol use patterns and identify potential alcohol misuse. The screening typically involves questions about drinking habits and takes between 5 to 15 minutes to complete. This is a preventive health service designed to identify alcohol-related concerns early and provide appropriate guidance or referrals if needed.
G1004Clinical decision support system from a national company
This code represents a clinical decision support mechanism provided by a national decision support company, as defined by Medicare's appropriate use criteria program. Clinical decision support systems are computer-based tools that help healthcare providers make better treatment decisions by providing evidence-based recommendations and guidelines at the point of care.
G0008Administration of flu vaccine
This code represents the service of giving a flu (influenza) vaccine to a patient. It covers the healthcare provider's work in administering the vaccine injection, including preparation, injection technique, and immediate monitoring. This is separate from the cost of the vaccine itself and specifically covers the administration service.
A7035Headgear component for sleep apnea breathing machines
This code covers the headgear (straps and fitting components) that holds the mask in place for positive airway pressure (PAP) devices. These devices are commonly used to treat sleep apnea by delivering pressurized air to keep airways open during sleep. The headgear is an essential component that ensures the mask stays properly positioned throughout the night for effective treatment.
G0179Doctor's review and approval to continue home health services
This code represents when a doctor or qualified healthcare provider reviews and re-certifies that a patient should continue receiving Medicare-covered home health services. The doctor reviews reports about the patient's condition and progress from the home health agency, then confirms that ongoing home health care is still medically necessary. This review happens without the patient being present and is required by Medicare to ensure continued coverage of home health services.
A4604Heated tubing for sleep apnea machines
This is a special type of tubing that connects to a CPAP, BiPAP, or other positive airway pressure machine used to treat sleep apnea and breathing disorders. The tubing has a built-in heating element that warms the air as it travels from the machine to your mask, helping to prevent condensation (water buildup) in the tube and making breathing more comfortable during sleep therapy.
G8756Documentation code indicating blood pressure was not measured during a medical visit
This is a tracking code used by healthcare providers to document that a patient's blood pressure was not measured during a medical encounter, and no specific reason was provided for why the measurement was not taken. This code helps healthcare systems monitor quality of care and ensure important vital signs like blood pressure are being checked when appropriate.
A4450Non-waterproof medical tape (18 square inches)
This code represents non-waterproof medical tape measured in units of 18 square inches. This type of tape is used for securing medical dressings, bandages, or medical devices to the skin. Unlike waterproof tape, this version is not designed to resist water or moisture, making it suitable for dry conditions or temporary applications where water resistance is not required.
G0439Follow-up annual wellness visit with personalized prevention plan
This code represents a subsequent (follow-up) annual wellness visit that includes creating or updating a personalized prevention plan of service (PPS). This is typically the second or later annual wellness visit, building on your previous wellness visit. During this visit, your healthcare provider will review your health status, update your personalized prevention plan based on your current health risks and needs, and discuss preventive care services that may be appropriate for you.
A7038Disposable filter for positive airway pressure (PAP) devices
This code represents a disposable filter that is used with positive airway pressure devices, such as CPAP or BiPAP machines. These filters help keep the air clean by removing dust, pollen, and other particles from the air that flows through your sleep apnea or breathing assistance device. The filter needs to be replaced regularly to maintain proper function and hygiene of your PAP equipment.
G0463Hospital outpatient clinic visit for patient assessment and management
This code represents a visit to a hospital's outpatient clinic where a healthcare provider evaluates and manages a patient's medical condition. This type of visit occurs when you receive care at a hospital-based clinic but are not admitted as an inpatient. The provider will assess your health status, review symptoms, and develop or adjust your treatment plan during this appointment.
A4223Medical supplies for IV infusion therapy without an external pump
This code covers the medical supplies needed to deliver medications or fluids directly into your bloodstream through an IV line, but without using an external infusion pump. This includes items like IV bags, cassettes, tubing, and other necessary supplies for the infusion process. The actual medications being given are billed separately from these supply costs.
A6403Medium-sized sterile gauze pad (larger than 16 square inches, up to 48 square inches)
This code represents a sterile gauze pad used for wound care and medical dressings. The gauze is non-impregnated (meaning it doesn't contain medications or other substances), sterile to prevent infection, and measures between 16 and 48 square inches in size. It does not have an adhesive border, so it would typically need to be secured with tape or other means. This is a single-use dressing item.
G8482Flu vaccination given or previously received
This code is used to document that you either received a flu (influenza) vaccination during your current visit, or that you had already received one previously. The flu vaccine helps protect against seasonal influenza viruses and is typically recommended annually for most people 6 months and older.
J3301Injection of triamcinolone acetonide, 10 mg dose
This code represents a 10 mg injection of triamcinolone acetonide, a corticosteroid medication. The 'not otherwise specified' designation means this code is used when the specific brand or formulation of triamcinolone acetonide isn't identified by other more specific codes. Triamcinolone acetonide is an anti-inflammatory steroid medication that can be injected into joints, muscles, or other body areas to reduce inflammation and pain.
G9903Documentation that patient was screened for tobacco use and identified as a non-tobacco user
This code is used by healthcare providers to document that they have screened a patient for tobacco use (such as cigarettes, cigars, chewing tobacco, or other tobacco products) and determined that the patient does not currently use tobacco. This screening is part of routine preventive healthcare and helps providers track tobacco use status for health monitoring and quality reporting purposes.
G0446Annual face-to-face behavioral therapy session for heart disease prevention (15 minutes)
This code represents a 15-minute, one-on-one counseling session with a healthcare provider focused on behavioral therapy for cardiovascular (heart) disease prevention. This is an annual service where the provider works with you individually to discuss and develop strategies for heart-healthy behaviors such as diet, exercise, smoking cessation, and stress management. The session must be conducted in person (face-to-face) and is specifically designed to help prevent or manage cardiovascular disease through behavioral interventions.
G8417Documentation that BMI is above normal range with follow-up plan recorded
This code indicates that a healthcare provider has calculated and documented that a patient's Body Mass Index (BMI) is above normal parameters (typically meaning overweight or obese range) and has also documented a specific follow-up plan to address this finding. BMI is a measurement that uses height and weight to estimate body fat and assess weight categories. This code represents the administrative tracking of proper documentation practices rather than a specific medical procedure or treatment.
G0180Doctor's certification for Medicare home health services
This code represents when a doctor or qualified healthcare provider officially certifies that a patient needs Medicare-covered home health services. The doctor reviews the patient's home health plan of care, communicates with the home health agency, and reviews status reports to confirm the patient qualifies for these services. This certification process happens without the patient being present during the doctor's review and approval process.
G0300Licensed practical nurse (LPN) care in home or hospice setting, billed per 15-minute period
This code represents direct skilled nursing services provided by a licensed practical nurse (LPN) in either a home health care or hospice care setting. The service is measured and billed in 15-minute increments. LPNs provide nursing care under the supervision of registered nurses or physicians, which may include medication administration, wound care, monitoring vital signs, and other skilled nursing tasks as part of your home-based or hospice care plan.
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