G0038 – Clinician determines patient does not require referral

Long description

Clinician determines patient does not require referral

Short description

Clin pt no ref

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2022

Last change

January 1, 2022 – No change

Nearby G codes

• G0030 – Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user
• G0031 – Palliative care services given to patient any time during the measurement period
• G0032 – Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics
• G0033 – Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement period and the ipsd for benzodiazepines
• G0034 – Patients receiving palliative care during the measurement period
• G0035 – Patient has any emergency department encounter during the performance period with place of service indicator 23
• G0036 – Patient or care partner decline assessment
• G0037 – On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available
• G0039 – Patient not referred, reason not otherwise specified
• G0040 – Patient already receiving physical/occupational/speech/recreational therapy during the measurement period
• G0041 – Patient and/or care partner decline referral
• G0042 – Referral to physical, occupational, speech, or recreational therapy
• G0043 – Patients with mechanical prosthetic heart valve
• G0044 – Patients with moderate or severe mitral stenosis
• G0045 – Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention
• G0046 – Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention