PQRS Measure
#109Osteoarthritis (OA): Function and Pain Assessment
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 99201 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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. |
| 1006F | 8P | N/A | 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 | N/A | N/A | 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 | N/A | 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 | N/A | N/A | 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] |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 715.00 | N/A | N/A | Osteoarthrosis, generalized, site unspecified |
| 715.04 | N/A | N/A | Osteoarthrosis, generalized, hand |
| 715.09 | N/A | N/A | Osteoarthrosis, generalized, multiple sites |
| 715.10 | N/A | N/A | Osteoarthrosis, localized, primary, site unspecified |
| 715.11 | N/A | N/A | Osteoarthrosis, localized, primary, shoulder region |
| 715.12 | N/A | N/A | Osteoarthrosis, localized, primary, upper arm |
| 715.13 | N/A | N/A | Osteoarthrosis, localized, primary, forearm |
| 715.14 | N/A | N/A | Osteoarthrosis, localized, primary, hand |
| 715.15 | N/A | N/A | Osteoarthrosis, localized, primary, pelvic region and thigh |
| 715.16 | N/A | N/A | Osteoarthrosis, localized, primary, lower leg |
| 715.17 | N/A | N/A | Osteoarthrosis, localized, primary, ankle and foot |
| 715.18 | N/A | N/A | Osteoarthrosis, localized, primary, other specified sites |
| 715.20 | N/A | N/A | Osteoarthrosis, localized, secondary, site unspecified |
| 715.21 | N/A | N/A | Osteoarthrosis, localized, secondary, shoulder region |
| 715.22 | N/A | N/A | Osteoarthrosis, localized, secondary, upper arm |
| 715.23 | N/A | N/A | Osteoarthrosis, localized, secondary, forearm |
| 715.24 | N/A | N/A | Osteoarthrosis, localized, secondary, hand |
| 715.25 | N/A | N/A | Osteoarthrosis, localized, secondary, pelvic region and thigh |
| 715.26 | N/A | N/A | Osteoarthrosis, localized, secondary, lower leg |
| 715.27 | N/A | N/A | Osteoarthrosis, localized, secondary, ankle and foot |
| 715.28 | N/A | N/A | Osteoarthrosis, localized, secondary, other specified sites |
| 715.30 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, site unspecified |
| 715.31 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, shoulder region |
| 715.32 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, upper arm |
| 715.33 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, forearm |
| 715.34 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, hand |
| 715.35 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh |
| 715.36 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, lower leg |
| 715.37 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, ankle and foot |
| 715.38 | N/A | N/A | Osteoarthrosis, localized, not specified whether primary or secondary, other specified sites |
| 715.80 | N/A | N/A | Osteoarthrosis involving, or with mention of more than one site, but not specified as generalized, site unspecified |
| 715.89 | N/A | N/A | Osteoarthrosis involving, or with mention of more than one site, but not specified as generalized, multiple sites |
| 715.90 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, site unspecified |
| 715.91 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, shoulder region |
| 715.92 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, upper arm |
| 715.93 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, forearm |
| 715.94 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, hand |
| 715.95 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh |
| 715.96 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, lower leg |
| 715.97 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, ankle and foot |
| 715.98 | N/A | N/A | Osteoarthrosis, unspecified whether generalized or localized, other specified sites |
Legend:
ClaimThis measure can be submitted via claim. Use the 'Data Collection' pdf associated with the measure.
GroupThis measure can be submitted through one or more groups. Click on the group name to view the group information.
RegistryThis measure can be submitted through registry.
EHRThis measure can be submitted via Electronic Health Record (EHR).
GPRO IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
ClaimThis measure can be submitted via claim. Use the 'Data Collection' pdf associated with the measure.
GroupThis measure can be submitted through one or more groups. Click on the group name to view the group information.
RegistryThis measure can be submitted through registry.
EHRThis measure can be submitted via Electronic Health Record (EHR).
GPRO IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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