| G9822 | Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date) |
| G9781 | Documentation of medical reason(s) for not currently being a statin therapy user or receiving an order (prescription) for statin therapy (e.g., patients with statin-associated muscle symptoms or an allergy to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease [esrd], or other medical reasons) |
| G9562 | Patients who had a follow-up evaluation conducted at least every three months during opioid therapy |
| G9563 | Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy |
| G2205 | Patients with pregnancy during adjuvant treatment course |
| M1271 | Patients with dementia at any time prior to or during the month |
| M1188 | Patients with a diagnosis of chronic kidney disease (ckd) stage 5 |
| M1187 | Patients with a diagnosis of end stage renal disease (esrd) |
| M1192 | Patients with an existing diagnosis of squamous cell carcinoma of the esophagus |
| G8860 | Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days |
| G8862 | Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days |
| G9774 | Patients who have had a hysterectomy |
| M1325 | Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment) |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches |
| G2187 | Patients with clinical indications for imaging of the head: head trauma |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck |
| G9667 | Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy) |
| G9800 | Patients who are identified as having an intolerance or allergy to beta-blocker therapy |
| M1261 | Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis |
| G9536 | Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms) |
| G0323 | Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team) |
| G9544 | Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement |
| G8873 | Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site) |
| M1264 | Patients age 75 or older on their initiation of dialysis date |
| M1186 | Patients who have an order for or are receiving hospice or palliative care |
| G8857 | Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness) |
| G8561 | Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure |
| G9346 | Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G8451 | Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons) |
| M1320 | Patients who screened positive for at least 1 of the 5 hrsns |
| 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 |
| M1039 | Patients with a diagnosis of lumbar spine region infection at the time of the procedure |
| M1037 | Patients with a diagnosis of lumbar spine region cancer at the time of the procedure |
| M1038 | Patients with a diagnosis of lumbar spine region fracture at the time of the procedure |
| G9646 | Patients with 90 day mrs score of 0 to 2 |
| G9659 | Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits |
| M1018 | Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients |
