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CMS126v5 Code List

Code List: CMS126v5, Use of Appropriate Medications for Asthma

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.

ItemCodes
Diagnosis Codes
Diagnosis: Persistent Asthma: ICD-10J45.30, J45.31, J45.32, J45.40, J45.41, J45.42, J45.50, J45.51, J45.52
Diagnosis: Persistent Asthma: SNOMED426656000, 426979002, 427295004, 5281000124103, 427354000, 901000119100
Encounter Codes
Encounter, Performed: Face-to-Face Interaction: SNOMED12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Encounter, Performed: Home Healthcare Services: CPT99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Encounter, Performed: Office Visit: CPT99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Preventive Care – Established Office Visit, 0 to 17: CPT99391, 99392, 99393, 99394
Encounter, Performed: Preventive Care Services – Established Office Visit, 18 and Up: CPT99395, 99396, 99397
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up: CPT99385, 99386, 99387
Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17: CPT99381, 99382, 99383, 99384
Medications
Medication, Dispensed: Preferred Asthma Therapy: Descriptions (RXNORM)100 ACTUAT Beclomethasone Dipropionate 0.04 MG/ACTUAT Metered Dose Inhaler, 100 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler, 100 ACTUAT flunisolide 0.25 MG/ACTUAT Metered Dose Inhaler, 12 HR zileuton 600 MG Extended Release Oral Tablet, 120 ACTUAT Beclomethasone Dipropionate 0.04 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.18 MG/ACTUAT Dry Powder Inhaler, 120 ACTUAT flunisolide 0.08 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.11 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT mometasone furoate 0.22 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT mometasone furoate 0.22 MG/ACTUAT Dry Powder Inhaler, 200 ACTUAT Beclomethasone Dipropionate 0.042 MG/ACTUAT Metered Dose Inhaler, 200 ACTUAT Beclomethasone Dipropionate 0.084 MG/ACTUAT Metered Dose Inhaler, 250 ML Theophylline 3.2 MG/ML Injection, 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler, 30 ACTUAT mometasone furoate 0.11 MG/ACTUAT Dry Powder Inhaler, 30 ACTUAT mometasone furoate 0.22 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Budesonide 0.09 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT ciclesonide 0.08 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT ciclesonide 0.16 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT flunisolide 0.08 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT mometasone furoate 0.22 MG/ACTUAT Dry Powder Inhaler, 7 ACTUAT mometasone furoate 0.11 MG/ACTUAT Dry Powder Inhaler, Aminophylline 100 MG Oral Tablet, Aminophylline 200 MG Oral Tablet, Aminophylline 21 MG/ML Oral Solution, Aminophylline 350 MG Extended Release Oral Tablet, Budesonide 0.08 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder, Budesonide 0.1 MG/ACTUAT Inhalant Powder, Budesonide 0.125 MG/ML Inhalant Solution, Budesonide 0.16 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder, Budesonide 0.2 MG/ACTUAT Inhalant Powder, Budesonide 0.25 MG/ML Inhalant Solution, Budesonide 0.4 MG/ACTUAT Inhalant Powder, Budesonide 0.5 MG/ML Inhalant Solution, Budesonide 3 MG Delayed Release Oral Capsule, Cromolyn Sodium 0.8 MG/ACTUAT Inhalant Powder, Cromolyn Sodium 10 MG/ML Inhalant Solution, Cromolyn Sodium 5 MG/ACTUAT Inhalant Powder, Dyphylline 10.7 MG/ML Oral Solution, Dyphylline 20 MG/ML / Guaifenesin 10 MG/ML Oral Solution, Dyphylline 20 MG/ML / Guaifenesin 20 MG/ML Oral Solution, Dyphylline 20 MG/ML / Guaifenesin 40 MG/ML Oral Solution, Dyphylline 200 MG / Guaifenesin 400 MG Oral Tablet, Dyphylline 200 MG Oral Tablet, Dyphylline 400 MG Oral Tablet, Dyphylline 6.67 MG/ML Oral Solution, Fluticasone propionate 0.22 MG/ACTUAT Inhalant Powder, Guaifenesin 180 MG / Theophylline 300 MG Oral Capsule, Guaifenesin 20 MG/ML / Theophylline 20 MG/ML Oral Solution, Guaifenesin 6 MG/ML / Theophylline 10 MG/ML Oral Solution, Guaifenesin 6.67 MG/ML / Theophylline 20 MG/ML Oral Solution, montelukast 10 MG Oral Tablet, montelukast 4 MG Chewable Tablet, montelukast 4 MG Oral Granules, montelukast 5 MG Chewable Tablet, Theophylline 100 MG Extended Release Oral Capsule, Theophylline 100 MG Extended Release Oral Tablet, Theophylline 100 MG Oral Capsule, Theophylline 125 MG Extended Release Oral Capsule, Theophylline 125 MG Oral Tablet, Theophylline 130 MG Extended Release Oral Capsule, Theophylline 175 MG Extended Release Oral Tablet, Theophylline 200 MG Extended Release Oral Capsule, Theophylline 200 MG Extended Release Oral Tablet, Theophylline 250 MG Extended Release Oral Tablet, Theophylline 250 MG Oral Tablet, Theophylline 300 MG Extended Release Oral Capsule, Theophylline 300 MG Extended Release Oral Tablet, Theophylline 300 MG Oral Tablet, Theophylline 400 MG Extended Release Oral Capsule, Theophylline 400 MG Extended Release Oral Tablet, Theophylline 450 MG Extended Release Oral Tablet, Theophylline 5.33 MG/ML Oral Solution, Theophylline 50 MG Extended Release Oral Capsule, Theophylline 50 MG Oral Tablet, Theophylline 500 MG Extended Release Oral Tablet, Theophylline 600 MG Extended Release Oral Tablet, Theophylline 65 MG Extended Release Oral Capsule, Theophylline 75 MG Extended Release Oral Capsule, zafirlukast 10 MG Oral Tablet, zafirlukast 20 MG Oral Tablet, zileuton 600 MG Oral Tablet
Exclusion Diagnosis Codes
Diagnosis: Acute Respiratory Failure: ICD-9518.81
Diagnosis: Acute Respiratory Failure: SNOMED397767007, 65710008, 67905004
Diagnosis: Chronic Obstructive Pulmonary Disease: ICD-9493.20, 493.21, 493.22, 496
Diagnosis: Chronic Obstructive Pulmonary Disease: ICD-10J44.0, J44.1, J44.9
Diagnosis: Chronic Obstructive Pulmonary Disease: SNOMED135836000, 13645005, 195951007, 196001008, 285381006, 313296004, 313297008, 313299006
Diagnosis: Obstructive Chronic Bronchitis: SNOMED185086009, 293241000119100
Diagnosis: Obstructive Chronic Bronchitis: ICD-9491.20, 491.21, 491.22
Diagnosis: Cystic Fibrosis: ICD-9277.00, 277.01, 277.02, 277.03, 277.09
Diagnosis: Cystic Fibrosis: SNOMED190905008, 190909002, 235978006, 81423003, 86092005, 86555001
Diagnosis: Emphysema: ICD-9492.0, 492.8, 506.4, 518.1, 518.2
Diagnosis: Emphysema: ICD-10J43.0, J43.1, J43.2, J43.8, J43.9, J68.4, J98.2, J98.3
Diagnosis: Emphysema: SNOMED16003001, 16846004, 195957006, 195958001, 195959009, 195963002, 196026004, 21072009, 233674008, 233675009, 233677001, 23958009, 266355005, 266356006, 2912004, 31898008, 33325001, 47895001, 4981000, 57686001, 60805002, 66110007, 66987001, 68328006, 70756004, 77690003, 86680006, 87433001, 16838000