Year:  2017 2018 2019 2020 2021 2022 2023 2024 2025 

QPP Measure #415

Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older

Percentage of emergency department visits for patients aged 18 years and older who presented with a minor blunt head trauma who had a head CT for trauma ordered by an emergency care clinician who have an indication for a head CT

Submission Methods: Claims, Registry
Measure Sets: Emergency Medicine

The following codes apply for this QPP measure:

CPT Codes

CodeDescription
99281CPT Code
99282CPT Code
99283CPT Code
99284CPT Code
99285CPT Code
99291CPT Code

HCPCS Codes

CodeDescription
G9529Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
G9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider
G9531Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar
G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma
G9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct

ICD10CM Codes

CodeDescription
S00.03XAContusion of scalp, initial encounter
S00.33XAContusion of nose, initial encounter
S00.431AContusion of right ear, initial encounter
S00.432AContusion of left ear, initial encounter
S00.439AContusion of unspecified ear, initial encounter
S00.531AContusion of lip, initial encounter
S00.532AContusion of oral cavity, initial encounter
S00.83XAContusion of other part of head, initial encounter
S00.93XAContusion of unspecified part of head, initial encounter
S02.0XXAFracture of vault of skull, initial encounter for closed fracture
S02.101AFracture of base of skull, right side, initial encounter for closed fracture
S02.102AFracture of base of skull, left side, initial encounter for closed fracture
S02.109AFracture of base of skull, unspecified side, initial encounter for closed fracture
S02.110AType I occipital condyle fracture, unspecified side, initial encounter for closed fracture
S02.111AType II occipital condyle fracture, unspecified side, initial encounter for closed fracture
S02.112AType III occipital condyle fracture, unspecified side, initial encounter for closed fracture
S02.113AUnspecified occipital condyle fracture, initial encounter for closed fracture
S02.118AOther fracture of occiput, unspecified side, initial encounter for closed fracture
S02.119AUnspecified fracture of occiput, initial encounter for closed fracture
S02.11AAType I occipital condyle fracture, right side, initial encounter for closed fracture
S02.11BAType I occipital condyle fracture, left side, initial encounter for closed fracture
S02.11CAType II occipital condyle fracture, right side, initial encounter for closed fracture
S02.11DAType II occipital condyle fracture, left side, initial encounter for closed fracture
S02.11EAType III occipital condyle fracture, right side, initial encounter for closed fracture
S02.11FAType III occipital condyle fracture, left side, initial encounter for closed fracture
S02.11GAOther fracture of occiput, right side, initial encounter for closed fracture
S02.11HAOther fracture of occiput, left side, initial encounter for closed fracture
S02.19XAOther fracture of base of skull, initial encounter for closed fracture
S02.2XXAFracture of nasal bones, initial encounter for closed fracture
S02.30XAFracture of orbital floor, unspecified side, initial encounter for closed fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed fracture
S02.32XAFracture of orbital floor, left side, initial encounter for closed fracture
S02.400AMalar fracture, unspecified side, initial encounter for closed fracture
S02.401AMaxillary fracture, unspecified side, initial encounter for closed fracture
S02.402AZygomatic fracture, unspecified side, initial encounter for closed fracture
S02.40AAMalar fracture, right side, initial encounter for closed fracture
S02.40BAMalar fracture, left side, initial encounter for closed fracture
S02.40CAMaxillary fracture, right side, initial encounter for closed fracture
S02.40DAMaxillary fracture, left side, initial encounter for closed fracture
S02.40EAZygomatic fracture, right side, initial encounter for closed fracture
S02.40FAZygomatic fracture, left side, initial encounter for closed fracture
S02.411ALeFort I fracture, initial encounter for closed fracture
S02.412ALeFort II fracture, initial encounter for closed fracture
S02.413ALeFort III fracture, initial encounter for closed fracture
S02.42XAFracture of alveolus of maxilla, initial encounter for closed fracture
S02.600AFracture of unspecified part of body of mandible, unspecified side, initial encounter for closed fracture
S02.601AFracture of unspecified part of body of right mandible, initial encounter for closed fracture
S02.602AFracture of unspecified part of body of left mandible, initial encounter for closed fracture
S02.609AFracture of mandible, unspecified, initial encounter for closed fracture
S02.610AFracture of condylar process of mandible, unspecified side, initial encounter for closed fracture
S02.611AFracture of condylar process of right mandible, initial encounter for closed fracture
S02.612AFracture of condylar process of left mandible, initial encounter for closed fracture
S02.620AFracture of subcondylar process of mandible, unspecified side, initial encounter for closed fracture
S02.621AFracture of subcondylar process of right mandible, initial encounter for closed fracture
S02.622AFracture of subcondylar process of left mandible, initial encounter for closed fracture
S02.630AFracture of coronoid process of mandible, unspecified side, initial encounter for closed fracture
S02.631AFracture of coronoid process of right mandible, initial encounter for closed fracture
S02.632AFracture of coronoid process of left mandible, initial encounter for closed fracture
S02.640AFracture of ramus of mandible, unspecified side, initial encounter for closed fracture
S02.641AFracture of ramus of right mandible, initial encounter for closed fracture
S02.642AFracture of ramus of left mandible, initial encounter for closed fracture
S02.650AFracture of angle of mandible, unspecified side, initial encounter for closed fracture
S02.651AFracture of angle of right mandible, initial encounter for closed fracture
S02.652AFracture of angle of left mandible, initial encounter for closed fracture
S02.66XAFracture of symphysis of mandible, initial encounter for closed fracture
S02.670AFracture of alveolus of mandible, unspecified side, initial encounter for closed fracture
S02.671AFracture of alveolus of right mandible, initial encounter for closed fracture
S02.672AFracture of alveolus of left mandible, initial encounter for closed fracture
S02.69XAFracture of mandible of other specified site, initial encounter for closed fracture
S02.80XAFracture of other specified skull and facial bones, unspecified side, initial encounter for closed fracture
S02.81XAFracture of other specified skull and facial bones, right side, initial encounter for closed fracture
S02.82XAFracture of other specified skull and facial bones, left side, initial encounter for closed fracture
S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed fracture
S06.0X0AConcussion without loss of consciousness, initial encounter
S06.0X1AConcussion with loss of consciousness of 30 minutes or less, initial encounter
S06.0X9AConcussion with loss of consciousness of unspecified duration, initial encounter
S06.1X0ATraumatic cerebral edema without loss of consciousness, initial encounter
S06.1X1ATraumatic cerebral edema with loss of consciousness of 30 minutes or less, initial encounter
S06.1X2ATraumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.1X3ATraumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.1X4ATraumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.1X9ATraumatic cerebral edema with loss of consciousness of unspecified duration, initial encounter
S06.2X0ADiffuse traumatic brain injury without loss of consciousness, initial encounter
S06.2X1ADiffuse traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter
S06.2X2ADiffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.2X3ADiffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.2X4ADiffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.2X9ADiffuse traumatic brain injury with loss of consciousness of unspecified duration, initial encounter
S06.300AUnspecified focal traumatic brain injury without loss of consciousness, initial encounter
S06.301AUnspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter
S06.302AUnspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.303AUnspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.304AUnspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.309AUnspecified focal traumatic brain injury with loss of consciousness of unspecified duration, initial encounter
S06.340ATraumatic hemorrhage of right cerebrum without loss of consciousness, initial encounter
S06.341ATraumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, initial encounter
S06.342ATraumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.343ATraumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter
S06.344ATraumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.349ATraumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, initial encounter
S06.350ATraumatic hemorrhage of left cerebrum without loss of consciousness, initial encounter
S06.351ATraumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, initial encounter
S06.352ATraumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.353ATraumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter
S06.354ATraumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.359ATraumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, initial encounter
S06.360ATraumatic hemorrhage of cerebrum, unspecified, without loss of consciousness, initial encounter
S06.361ATraumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter
S06.362ATraumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.363ATraumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter
S06.364ATraumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.369ATraumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter
S06.4X0AEpidural hemorrhage without loss of consciousness, initial encounter
S06.4X1AEpidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter
S06.4X2AEpidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.4X3AEpidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.4X4AEpidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.4X9AEpidural hemorrhage with loss of consciousness of unspecified duration, initial encounter
S06.5X0ATraumatic subdural hemorrhage without loss of consciousness, initial encounter
S06.5X1ATraumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter
S06.5X2ATraumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.5X3ATraumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.5X4ATraumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.5X9ATraumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter
S06.6X0ATraumatic subarachnoid hemorrhage without loss of consciousness, initial encounter
S06.6X1ATraumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, initial encounter
S06.6X2ATraumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.6X3ATraumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.6X4ATraumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.6X9ATraumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial encounter
S06.810AInjury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter
S06.811AInjury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter
S06.812AInjury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.813AInjury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.814AInjury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.819AInjury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter
S06.820AInjury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter
S06.821AInjury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter
S06.822AInjury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.823AInjury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.824AInjury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.829AInjury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter
S06.890AOther specified intracranial injury without loss of consciousness, initial encounter
S06.891AOther specified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter
S06.892AOther specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.893AOther specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.894AOther specified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.899AOther specified intracranial injury with loss of consciousness of unspecified duration, initial encounter
S06.9X0AUnspecified intracranial injury without loss of consciousness, initial encounter
S06.9X1AUnspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter
S06.9X2AUnspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.9X3AUnspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.9X4AUnspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.9X9AUnspecified intracranial injury with loss of consciousness of unspecified duration, initial encounter
S09.10XAUnspecified injury of muscle and tendon of head, initial encounter
S09.11XAStrain of muscle and tendon of head, initial encounter
S09.19XAOther specified injury of muscle and tendon of head, initial encounter
S09.8XXAOther specified injuries of head, initial encounter
S09.90XAUnspecified injury of head, initial encounter
S09.92XAUnspecified injury of nose, initial encounter
S09.93XAUnspecified injury of face, initial encounter
S10.0XXAContusion of throat, initial encounter
S10.83XAContusion of other specified part of neck, initial encounter
S10.93XAContusion of unspecified part of neck, initial encounter
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