HCPCS Code Section: HCPCS G Codes

Nortriptyline Short Description: Assay of nortiptyline Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Assay of imipramine Short Description: Assay of imipramine Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 …

Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given Short Description: Pt w/dxa no results doc Coverage Code: Carrier judgment Action Code: No maintenance for …

Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed Short Description: Pt w/dxa results document Coverage Code: Carrier judgment Action Code: No maintenance for …

Dilated macular or fundus exam not performed Short Description: Dil macular/fundus not perfo Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2008 …

Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy Short Description: Dil macula/fundus exam/w doc Coverage …

Left ventricular ejection fraction (lvef) not performed or documented Short Description: Lvef not performed Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function Short Description: Lvef>=40% doc normal or mild Coverage Code: Carrier judgment …

Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure Short Description: Pt inelig for antidepres med Coverage …

Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase Short Description: Pt not …