Summary & Overview
HCPCS G8552: Ischemic Vascular Disease Quality Actions Completed
HCPCS Level II code G8552 denotes that all required quality actions for the ischemic vascular disease (IVD) measures group have been completed for a patient. As a performance-reporting code, it documents that clinicians have fulfilled specified quality processes tied to IVD care, supporting quality measurement, reporting, and value-based programs. Nationally, consistent use of this code contributes to benchmarking of care quality and administrative tracking of compliance with clinical performance measures.
Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context and administrative role of the code, what sites of service typically use it, and which payers commonly recognize performance-reporting codes in contracting and quality programs. The publication also summarizes benchmark considerations, recent policy trends affecting quality-measure reporting, and practical claims-processing implications for outpatient practices and specialty clinics.
Intended for clinicians, billing staff, and policy analysts, the piece clarifies the role of G8552 within quality measurement frameworks and outlines what to expect from payer coverage and reporting practices. Data not available in the input.
Billing Code Overview
HCPCS Level II code G8552 indicates that all quality actions for the applicable measures in the ischemic vascular disease (IVD) measures group have been performed for this patient. This reflects completion of the set of documented clinical quality tasks associated with IVD care.
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Service type: Quality reporting / performance measure documentation
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Typical site of service: Outpatient clinical settings where ischemic vascular disease care and quality reporting occur, such as primary care clinics, cardiology practices, and vascular specialty clinics.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old male with a history of coronary artery disease and peripheral arterial disease who presents for a chronic disease management visit focused on secondary prevention after an ischemic vascular event (myocardial infarction or ischemic stroke). The clinical workflow includes: documentation of the ischemic vascular disease (IVD) diagnosis, review of current medications (antiplatelet therapy, statin, antihypertensive agents), assessment of blood pressure and lipid control, counseling on smoking cessation and lifestyle modification, reconciliation of medications, and scheduling follow-up. The clinician confirms that all quality actions specified in the IVD measures group have been completed for the patient during the measurement period, supporting billing under G8552 which indicates all applicable IVD measure actions were performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | When a distinct E/M visit is provided the same day as a preventive or chronic-care procedure supporting the quality actions |
59 |