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  2. CQM-7553

Question about CY2025 CPT code used in CMS506v7 - Safe Use of Opioids eCQM

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      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. Please see below for answers to your questions:

      1. Is "HG" a CPT code or a modifier to the CPT code? We ask because a CPT code is usually a 5 alphanumeric character code.

      “HG” is a HCPCS modifier; it is not a CPT or HCPCS code.

      2. Is it appropriate to use this modifier code by itself without an associated CPT code?

      It is not appropriate to use this modifier code by itself without an associated HCPCS code. We will explore updates to this value set in future annual updates.

      3. Is it appropriate to use the CPT Code System OID for this modifier - 2.16.840.1.113883.6.12, even though no CPT code is being captured?

      Yes, it is appropriate to use the CPT Code System OID (2.16.840.1.113883.6.12) for this modifier even though no CPT code is being captured.
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      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. Please see below for answers to your questions: 1. Is "HG" a CPT code or a modifier to the CPT code? We ask because a CPT code is usually a 5 alphanumeric character code. “HG” is a HCPCS modifier; it is not a CPT or HCPCS code. 2. Is it appropriate to use this modifier code by itself without an associated CPT code? It is not appropriate to use this modifier code by itself without an associated HCPCS code. We will explore updates to this value set in future annual updates. 3. Is it appropriate to use the CPT Code System OID for this modifier - 2.16.840.1.113883.6.12, even though no CPT code is being captured? Yes, it is appropriate to use the CPT Code System OID (2.16.840.1.113883.6.12) for this modifier even though no CPT code is being captured.
    • CMS0506v7

      CMS506v7 - Safe Use of Opioids for CY2025 uses a new valueset called - "Opioid Medication Assisted Treatment (MAT)" (2.16.840.1.113762.1.4.1111.177). 

      The valueset has a CPT code in the valueset files from VSAC. This CPT code is "HG" (see screenshot from VSAC file below). 

      Questions -

      1. Is "HG" a CPT code or a modifier to the CPT code? We ask because a CPT code is usually a 5 alphanumeric character code. 

      2. Is it appropriate to use this modifier code by itself without an associated CPT code? 

      3. Is it appropriate to use the CPT CodeSystem OID for this modifier - 2.16.840.1.113883.6.12, even though no CPT code is being captured?

      We would appreciate clarification related to the above questions. Thanks. 

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            aweber Mathematica EH eCQM Team
            mparekhji Manish Parekhji
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