PQRS Measure
#138Melanoma: Coordination of Care
This measure may be submitted via Registry only
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 11600 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less |
| 11601 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm |
| 11602 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm |
| 11603 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm |
| 11604 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm |
| 11606 | N/A | N/A | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm |
| 11620 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less |
| 11621 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm |
| 11622 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm |
| 11623 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm |
| 11624 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm |
| 11626 | N/A | N/A | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm |
| 11640 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less |
| 11641 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm |
| 11642 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm |
| 11643 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm |
| 11644 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm |
| 11646 | N/A | N/A | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm |
| 14000 | N/A | N/A | Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less |
| 14001 | N/A | N/A | Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm |
| 14020 | N/A | N/A | Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less |
| 14021 | N/A | N/A | Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm |
| 14040 | N/A | N/A | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less |
| 14041 | N/A | N/A | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm |
| 14060 | N/A | N/A | Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less |
| 14061 | N/A | N/A | Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm |
| 14301 | N/A | N/A | Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm |
| 14302 | N/A | N/A | Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure) |
| 17311 | N/A | N/A | Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks |
| 17313 | N/A | N/A | Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks |
| 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. |
| 5050F | 2P | N/A | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) |
| 5050F | 3P | N/A | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) |
| 5050F | 8P | N/A | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) |
| 5050F | N/A | N/A | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 172.0 | N/A | N/A | Malignant melanoma of skin of lip |
| 172.1 | N/A | N/A | Malignant melanoma of skin of eyelid, including canthus |
| 172.2 | N/A | N/A | Malignant melanoma of skin of ear and external auditory canal |
| 172.3 | N/A | N/A | Malignant melanoma of skin of other and unspecified parts of face |
| 172.4 | N/A | N/A | Malignant melanoma of skin of scalp and neck |
| 172.5 | N/A | N/A | Malignant melanoma of skin of trunk, except scrotum |
| 172.6 | N/A | N/A | Malignant melanoma of skin of upper limb, including shoulder |
| 172.7 | N/A | N/A | Malignant melanoma of skin of lower limb, including hip |
| 172.8 | N/A | N/A | Malignant melanoma of other specified sites of skin |
| 172.9 | N/A | N/A | Melanoma of skin, site unspecified |
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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