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CMS129v7 Code List

Code List: CMS129v7, Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

MicroMD uses the following code lists to determine a patient’s inclusion in this measure.  To search for your code, simply press Ctrl + F on your keyboard, enter your code in the search field and press Enter on your keyboard.

This user-friendly code list is provided as a courtesy to our MicroMD users.  For more in-depth information about codes and/or criteria or to compare version changes, visit the CMS eCQI Resource Center at https://ecqi.healthit.gov/ (no user account required) or the United States Health Information Knowledgebase at https://ushik.ahrq.gov/mdr/portals (requires a free user account to view codes).

Item Codes
Diagnosis Codes
Diagnosis: Prostate Cancer: ICD-9 185
Diagnosis: Prostate Cancer: ICD-10 C61
Diagnosis: Prostate Cancer: SNOMED 254900004, 278060005, 314969001, 369485004, 369486003, 396198006, 399068003, 399490008, 399590005, 427492003, 93974005, 94503003
Bone Scan Procedure Codes
Diagnostic Study, Performed: Bone Scan: LOINC 25031-6, 25032-4, 39627-5, 39814-9, 39812-3, 39815-6, 39819-8, 39813-1, 39816-4, 39820-6, 39817-2, 39818-0, 39858-6, 39881-8, 39882-6, 39879-2, 39883-4, 39880-0, 39884-2, 39904-8, 39901-4, 39902-2, 39905-5, 39903-0, 41772-5, 41836-8, 42700-5, 44142-8
Gleason LOINC Codes
Laboratory Test, Performed: Gleason Score: LOINC 35266-6
Laboratory Antigen LOINC Codes
Laboratory Test, Performed: Prostate Specific Antigen Test: LOINC 2857-1, 10508-0, 10886-0, 12841-3, 15323-9, 15324-7, 15325-4, 19195-7, 19201-3, 33667-7, 34611-4, 35741-8
Cancer Treatment Procedure Codes
Procedure, Performed: Prostate Cancer Treatment: CPT 55810, 55812, 55815, 55840, 55842, 55845, 55866, 55873, 55875, 77427, 77435, 77772, 77778, 77799
Procedure, Performed: Prostate Cancer Treatment: SNOMED 10492003, 113120007, 116244007, 118161009, 118162002, 118163007, 14473006, 168922004, 169327006, 169328001, 169329009, 169340001, 169349000, 169359004, 169374002, 176106009, 176258007, 176260009, 176261008, 176262001, 176263006, 176267007, 176286004, 176288003, 176319004, 19149007, 21190008, 21372000, 228677009, 228684001, 228688003, 228690002, 228692005, 228693000, 228694006, 228695007, 228697004, 228698009, 228699001, 228701001, 228702008, 236252003, 24242005, 26294005, 265589001, 271291003, 27877006, 28579000, 29860002, 30426000, 312235007, 314202001, 359922007, 359926005, 36253005, 37851009, 384691004, 384692006, 38915000, 394902000, 394918006, 399124002, 399180008, 399315003, 41371003, 41416003, 420529003, 427357007, 427985002, 433224001, 433225000, 440093006, 440094000, 57525009, 62867004, 64978007, 65381004, 65551008, 67598001, 68986004, 72388004, 77613002, 81232004, 83154001, 84755001, 85768003, 87795007, 8782006, 90199006, 90470006, 91531008
Cancer Staging Codes
Procedure, Performed: Cancer Staging: SNOMED 258232002
Exclusion Diagnosis Codes
Diagnosis: Pain Related to Prostate Cancer: ICD-9 338.3, 724.1, 724.5, 724.6, 724.79, 733.90, 786.50, 786.59, 789.00, V76.44, V84.03
Diagnosis: Pain Related to Prostate Cancer: ICD-10 G89.3, M43.27, M43.28, M53.2X7, M53.2X8, M53.3, M53.86, M53.87, M53.88, M54.6, M54.89, M54.9, M85.9, M89.9, M94.9, R07.82, R07.89, R07.9, R10.0, R10.9, Z12.5, Z15.03
Diagnosis: Pain Related to Prostate Cancer: SNOMED 12584003, 161977000, 203508001, 203509009, 20793008, 267981009, 282743009, 297217002, 298731003, 298740004, 301773003, 3200003, 34789001, 36729000, 426135001, 48926009, 89638008
Exclusion Procedure Codes
Procedure, Performed: Salvage Therapy: CPT 51597, 55860, 55862, 55865
Procedure, Performed: Salvage Therapy: SNOMED 236209003, 236211007
Exclusion Valid Reasons Documentation
Reason: Reason Documented 433611000124109 – Procedure reason record (record artifact)

Last updated: May 16, 2018 at 2:37 pm