PQRS Measure
#109Osteoarthritis (OA): Function and Pain Assessment
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 1006F | Osteoarthritis symptoms and functional status assessed (may include the use of a standardized scale or the completion of an assessment questionnaire, such as the SF-36, AAOS Hip & Knee Questionnaire) (OA) [Instructions: Report when osteoarthritis is addressed during the patient encounter] | ||
| 1006F | 8P | Osteoarthritis symptoms and functional status assessed (may include the use of a standardized scale or the completion of an assessment questionnaire, such as the SF-36, AAOS Hip & Knee Questionnaire) (OA) [Instructions: Report when osteoarthritis is addressed during the patient encounter] | |
| 99201 | Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family. | ||
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. | ||
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. | ||
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. | ||
| 99205 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. | ||
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded. | ||
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded. | ||
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. | ||
| 99215 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 715.00 | Osteoarthrosis, generalized, site unspecified | ||
| 715.04 | Osteoarthrosis, generalized, hand | ||
| 715.09 | Osteoarthrosis, generalized, multiple sites | ||
| 715.10 | Osteoarthrosis, localized, primary, site unspecified | ||
| 715.11 | Osteoarthrosis, localized, primary, shoulder region | ||
| 715.12 | Osteoarthrosis, localized, primary, upper arm | ||
| 715.13 | Osteoarthrosis, localized, primary, forearm | ||
| 715.14 | Osteoarthrosis, localized, primary, hand | ||
| 715.15 | Osteoarthrosis, localized, primary, pelvic region and thigh | ||
| 715.16 | Osteoarthrosis, localized, primary, lower leg | ||
| 715.17 | Osteoarthrosis, localized, primary, ankle and foot | ||
| 715.18 | Osteoarthrosis, localized, primary, other specified sites | ||
| 715.20 | Osteoarthrosis, localized, secondary, site unspecified | ||
| 715.21 | Osteoarthrosis, localized, secondary, shoulder region | ||
| 715.22 | Osteoarthrosis, localized, secondary, upper arm | ||
| 715.23 | Osteoarthrosis, localized, secondary, forearm | ||
| 715.24 | Osteoarthrosis, localized, secondary, hand | ||
| 715.25 | Osteoarthrosis, localized, secondary, pelvic region and thigh | ||
| 715.26 | Osteoarthrosis, localized, secondary, lower leg | ||
| 715.27 | Osteoarthrosis, localized, secondary, ankle and foot | ||
| 715.28 | Osteoarthrosis, localized, secondary, other specified sites | ||
| 715.30 | Osteoarthrosis, localized, not specified whether primary or secondary, site unspecified | ||
| 715.31 | Osteoarthrosis, localized, not specified whether primary or secondary, shoulder region | ||
| 715.32 | Osteoarthrosis, localized, not specified whether primary or secondary, upper arm | ||
| 715.33 | Osteoarthrosis, localized, not specified whether primary or secondary, forearm | ||
| 715.34 | Osteoarthrosis, localized, not specified whether primary or secondary, hand | ||
| 715.35 | Osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh | ||
| 715.36 | Osteoarthrosis, localized, not specified whether primary or secondary, lower leg | ||
| 715.37 | Osteoarthrosis, localized, not specified whether primary or secondary, ankle and foot | ||
| 715.38 | Osteoarthrosis, localized, not specified whether primary or secondary, other specified sites | ||
| 715.80 | Osteoarthrosis involving, or with mention of more than one site, but not specified as generalized, site unspecified | ||
| 715.89 | Osteoarthrosis involving, or with mention of more than one site, but not specified as generalized, multiple sites | ||
| 715.90 | Osteoarthrosis, unspecified whether generalized or localized, site unspecified | ||
| 715.91 | Osteoarthrosis, unspecified whether generalized or localized, shoulder region | ||
| 715.92 | Osteoarthrosis, unspecified whether generalized or localized, upper arm | ||
| 715.93 | Osteoarthrosis, unspecified whether generalized or localized, forearm | ||
| 715.94 | Osteoarthrosis, unspecified whether generalized or localized, hand | ||
| 715.95 | Osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh | ||
| 715.96 | Osteoarthrosis, unspecified whether generalized or localized, lower leg | ||
| 715.97 | Osteoarthrosis, unspecified whether generalized or localized, ankle and foot | ||
| 715.98 | Osteoarthrosis, unspecified whether generalized or localized, other specified sites | ||
Legend:
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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