G9521 Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months

Billable / valid for submission HCPCS Release 2026Q3

Short description: Er and ip hosp <2 in 12 mos

Version history

Related codes in G95

• G9500 Radiation exposure indices documented in final report for procedure using fluoroscopy
• G9501 Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given
• G9502 Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
• G9504 Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
• G9505 Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
• G9507 Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
• G9508 Documentation that the patient is not on a statin medication
• G9509 Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
• G9510 Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5
• G9511 Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
• G9512 Individual had a pdc of 0.8 or greater
• G9513 Individual did not have a pdc of 0.8 or greater
• G9514 Patient required a return to the operating room within 90 days of surgery
• G9515 Patient did not require a return to the operating room within 90 days of surgery
• G9516 Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
• G9517 Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
• G9518 Documentation of active injection drug use
• G9519 Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
• G9520 Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
• G9522 Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given

All G95 codes →