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CMS130v6 Code List

Code List: CMS130v6, Colorectal Cancer Screening

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
Encounter Codes
Encounter, Performed: Annual Wellness Visit: HCPCS G0438, G0439
Encounter, Performed: Face-to-Face Interaction: SNOMED 12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Encounter, Performed: Home Healthcare Services: CPT 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Encounter, Performed: Office Visit: CPT 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Preventive Care Services – Established Office Visit, 18 and Up: CPT 99395, 99396, 99397
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up: CPT 99385, 99386, 99387
Colonoscopy Codes
Procedure, Performed: Colonoscopy: HCPCS G0105, G0121
Procedure, Performed: Colonoscopy: CPT 44388, 44389, 44390, 44391, 44392, 44393, 44394, 44397, 44401, 44402, 44403, 44404, 44405, 44406, 44407, 44408, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, 45385, 45386, 45387, 45388, 45389, 45390, 45391, 45392, 45393, 45398
Procedure, Performed: Colonoscopy: SNOMED 12350003, 174158000, 174184006, 235150006, 235151005, 25732003, 303587008, 310634005, 34264006, 367535003, 427459009, 443998000, 444783004, 446521004, 446745002, 447021001, 73761001, 8180007
CT Colonography Codes
Procedure, Performed: CT Colonography: CPT 74263
Procedure, Performed: CT Colonography: SNOMED 418714002
Sigmoidoscopy Codes
Procedure, Performed: Flexible Sigmoidoscopy: HCPCS G0104
Procedure, Performed: Flexible Sigmoidoscopy: CPT 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45339, 45340, 45341, 45342, 45345, 45346, 45347, 45349, 45350
Procedure, Performed: Flexible Sigmoidoscopy: SNOMED 112870002, 396226005, 425634007, 44441009
Laboratory Codes
Laboratory Test, Performed: Fecal Occult Blood Test (FOBT): LOINC 2335-8, 12503-9, 12504-7, 14564-9, 14565-6, 14563-1, 27401-9, 27396-1, 27925-7, 27926-5, 29771-3, 56490-6, 56491-4, 57905-2, 58453-2, 80372-6
Laboratory Test, Performed: FIT DNA: LOINC 77353-1, 77354-9
Exclusion Diagnosis Codes
Diagnosis: Malignant Neoplasm of Colon: ICD-9 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 197.5
Diagnosis: Malignant Neoplasm of Colon: ICD-10 C18.0, C18.1, C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21.2, C21.8, C78.5, C7A.021, C7A.022, C7A.023, C7A.024, C7A.025, C7A.026
Diagnosis: Malignant Neoplasm of Colon: SNOMED 109838007, 123701000119104, 123721000119108, 130381000119103, 133751000119102, 1701000119104, 184881000119106, 187757001, 187758006, 269533000, 269544008, 285312008, 285611007, 301756000, 312111009, 312112002, 312113007, 312114001, 312115000, 314965007, 315058005, 363406005, 363407001, 363408006, 363409003, 363410008, 363412000, 363413005, 363414004, 363510005, 425178004, 449218003, 681601000119101, 716654007, 721695008, 721696009, 721697000, 721698005, 721699002, 93683002, 93761005, 93771007, 93826009, 93980002, 94006002, 94072004, 94105000, 94179005, 94260004, 94271003, 94328005, 94509004, 94538001, 94604000, 94643001, 96281000119107, 96981000119102
Exclusion Procedure Codes
Procedure, Performed: Total Colectomy: CPT 44150, 44151, 44152, 44153, 44155, 44156, 44157, 44158, 44210, 44211, 44212
Procedure, Performed: Total Colectomy: SNOMED 235331003, 26390003, 303401008, 307666008, 307667004, 307669001, 31130001, 36192008, 44751009, 456004, 80294005
Hospice Exclusion Codes
Encounter, Performed: Encounter Inpatient 183452005, 32485007, 8715000
Intervention, Order: Hospice Care 385763009, 385765002
Discharge Codes to Health Care Facility for Hospice Care 428371000124100
Discharge Codes to Home for Hospice Care 428361000124107

Last updated: June 11, 2018 at 1:07 pm