Year:  2017 2018 2019 2020 2021 2022 2023 2024 2025 

QPP Measure #419

Overuse of Imaging for the Evaluation of Primary Headache

Percentage of patients for whom imaging of the head (CT or MRI) is obtained for the evaluation of primary headache when clinical indications are not present

Submission Methods: Claims, Registry
Measure Sets: Neurology

The following codes apply for this QPP measure:

CPT Codes

CodeDescription
99201CPT Code
99202CPT Code
99203CPT Code
99204CPT Code
99205CPT Code
99211CPT Code
99212CPT Code
99213CPT Code
99214CPT Code
99215CPT Code
99221CPT Code
99222CPT Code
99223CPT Code
99231CPT Code
99232CPT Code
99233CPT Code
99238CPT Code
99239CPT Code
99241CPT Code
99242CPT Code
99243CPT Code
99244CPT Code
99245CPT Code

HCPCS Codes

CodeDescription
G9537Imaging needed as part of a clinical trial; or other clinician ordered the study
M1027Imaging of the head (ct or mri) was obtained
M1028Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
M1029Imaging of the head (ct or mri) was not obtained, reason not given
M1030Patients with clinical indications for imaging of the head
M1031Patients with no clinical indications for imaging of the head

ICD10CM Codes

CodeDescription
G43.001Migraine without aura, not intractable, with status migrainosus
G43.009Migraine without aura, not intractable, without status migrainosus
G43.011Migraine without aura, intractable, with status migrainosus
G43.019Migraine without aura, intractable, without status migrainosus
G43.101Migraine with aura, not intractable, with status migrainosus
G43.109Migraine with aura, not intractable, without status migrainosus
G43.111Migraine with aura, intractable, with status migrainosus
G43.119Migraine with aura, intractable, without status migrainosus
G43.401Hemiplegic migraine, not intractable, with status migrainosus
G43.409Hemiplegic migraine, not intractable, without status migrainosus
G43.411Hemiplegic migraine, intractable, with status migrainosus
G43.501Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus
G43.509Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus
G43.511Persistent migraine aura without cerebral infarction, intractable, with status migrainosus
G43.519Persistent migraine aura without cerebral infarction, intractable, without status migrainosus
G43.601Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus
G43.609Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus
G43.611Persistent migraine aura with cerebral infarction, intractable, with status migrainosus
G43.619Persistent migraine aura with cerebral infarction, intractable, without status migrainosus
G43.701Chronic migraine without aura, not intractable, with status migrainosus
G43.709Chronic migraine without aura, not intractable, without status migrainosus
G43.711Chronic migraine without aura, intractable, with status migrainosus
G43.719Chronic migraine without aura, intractable, without status migrainosus
G43.801Other migraine, not intractable, with status migrainosus
G43.809Other migraine, not intractable, without status migrainosus
G43.811Other migraine, intractable, with status migrainosus
G43.819Other migraine, intractable, without status migrainosus
G43.821Menstrual migraine, not intractable, with status migrainosus
G43.829Menstrual migraine, not intractable, without status migrainosus
G43.831Menstrual migraine, intractable, with status migrainosus
G43.839Menstrual migraine, intractable, without status migrainosus
G43.901Migraine, unspecified, not intractable, with status migrainosus
G43.909Migraine, unspecified, not intractable, without status migrainosus
G43.911Migraine, unspecified, intractable, with status migrainosus
G43.919Migraine, unspecified, intractable, without status migrainosus
G44.009Cluster headache syndrome, unspecified, not intractable
G44.019Episodic cluster headache, not intractable
G44.029Chronic cluster headache, not intractable
G44.039Episodic paroxysmal hemicrania, not intractable
G44.049Chronic paroxysmal hemicrania, not intractable
G44.059Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), not intractable
G44.099Other trigeminal autonomic cephalgias (TAC), not intractable
G44.1Vascular headache, not elsewhere classified
G44.209Tension-type headache, unspecified, not intractable
G44.219Episodic tension-type headache, not intractable
G44.221Chronic tension-type headache, intractable
G44.229Chronic tension-type headache, not intractable
G44.51Hemicrania continua
G44.52New daily persistent headache (NDPH)
G44.53Primary thunderclap headache
G44.59Other complicated headache syndrome
G44.81Hypnic headache
G44.82Headache associated with sexual activity
G44.83Primary cough headache
G44.84Primary exertional headache
G44.85Primary stabbing headache
G44.89Other headache syndrome
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