PQRS Information

Year: 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007

PQRS Measure

This measure may be submitted via Registry only

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
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
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
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	N/A	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)
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	N/A	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)
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
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
ICD10CM Codes
Code	Modifier	POS	Description
C43.0	N/A	N/A	Malignant melanoma of lip
C43.10	N/A	N/A	Malignant melanoma of unspecified eyelid, including canthus
C43.11	N/A	N/A	Malignant melanoma of right eyelid, including canthus
C43.12	N/A	N/A	Malignant melanoma of left eyelid, including canthus
C43.20	N/A	N/A	Malignant melanoma of unspecified ear and external auricular canal
C43.21	N/A	N/A	Malignant melanoma of right ear and external auricular canal
C43.22	N/A	N/A	Malignant melanoma of left ear and external auricular canal
C43.30	N/A	N/A	Malignant melanoma of unspecified part of face
C43.31	N/A	N/A	Malignant melanoma of nose
C43.39	N/A	N/A	Malignant melanoma of other parts of face
C43.4	N/A	N/A	Malignant melanoma of scalp and neck
C43.51	N/A	N/A	Malignant melanoma of anal skin
C43.52	N/A	N/A	Malignant melanoma of skin of breast
C43.59	N/A	N/A	Malignant melanoma of other part of trunk
C43.60	N/A	N/A	Malignant melanoma of unspecified upper limb, including shoulder
C43.61	N/A	N/A	Malignant melanoma of right upper limb, including shoulder
C43.62	N/A	N/A	Malignant melanoma of left upper limb, including shoulder
C43.70	N/A	N/A	Malignant melanoma of unspecified lower limb, including hip
C43.71	N/A	N/A	Malignant melanoma of right lower limb, including hip
C43.72	N/A	N/A	Malignant melanoma of left lower limb, including hip
C43.8	N/A	N/A	Malignant melanoma of overlapping sites of skin
C43.9	N/A	N/A	Malignant melanoma of skin, unspecified
D03.0	N/A	N/A	Melanoma in situ of lip
D03.10	N/A	N/A	Melanoma in situ of unspecified eyelid, including canthus
D03.11	N/A	N/A	Melanoma in situ of right eyelid, including canthus
D03.12	N/A	N/A	Melanoma in situ of left eyelid, including canthus
D03.20	N/A	N/A	Melanoma in situ of unspecified ear and external auricular canal
D03.21	N/A	N/A	Melanoma in situ of right ear and external auricular canal
D03.22	N/A	N/A	Melanoma in situ of left ear and external auricular canal
D03.30	N/A	N/A	Melanoma in situ of unspecified part of face
D03.39	N/A	N/A	Melanoma in situ of other parts of face
D03.4	N/A	N/A	Melanoma in situ of scalp and neck
D03.51	N/A	N/A	Melanoma in situ of anal skin
D03.52	N/A	N/A	Melanoma in situ of breast (skin) (soft tissue)
D03.59	N/A	N/A	Melanoma in situ of other part of trunk
D03.60	N/A	N/A	Melanoma in situ of unspecified upper limb, including shoulder
D03.61	N/A	N/A	Melanoma in situ of right upper limb, including shoulder
D03.62	N/A	N/A	Melanoma in situ of left upper limb, including shoulder
D03.70	N/A	N/A	Melanoma in situ of unspecified lower limb, including hip
D03.71	N/A	N/A	Melanoma in situ of right lower limb, including hip
D03.72	N/A	N/A	Melanoma in situ of left lower limb, including hip
D03.8	N/A	N/A	Melanoma in situ of other sites
D03.9	N/A	N/A	Melanoma in situ, unspecified
C43.0	N/A	N/A	Malignant melanoma of lip
C43.10	N/A	N/A	Malignant melanoma of unspecified eyelid, including canthus
C43.11	N/A	N/A	Malignant melanoma of right eyelid, including canthus
C43.12	N/A	N/A	Malignant melanoma of left eyelid, including canthus
C43.20	N/A	N/A	Malignant melanoma of unspecified ear and external auricular canal
C43.21	N/A	N/A	Malignant melanoma of right ear and external auricular canal
C43.22	N/A	N/A	Malignant melanoma of left ear and external auricular canal
C43.30	N/A	N/A	Malignant melanoma of unspecified part of face
C43.31	N/A	N/A	Malignant melanoma of nose
C43.39	N/A	N/A	Malignant melanoma of other parts of face
C43.4	N/A	N/A	Malignant melanoma of scalp and neck
C43.51	N/A	N/A	Malignant melanoma of anal skin
C43.52	N/A	N/A	Malignant melanoma of skin of breast
C43.59	N/A	N/A	Malignant melanoma of other part of trunk
C43.60	N/A	N/A	Malignant melanoma of unspecified upper limb, including shoulder
C43.61	N/A	N/A	Malignant melanoma of right upper limb, including shoulder
C43.62	N/A	N/A	Malignant melanoma of left upper limb, including shoulder
C43.70	N/A	N/A	Malignant melanoma of unspecified lower limb, including hip
C43.71	N/A	N/A	Malignant melanoma of right lower limb, including hip
C43.72	N/A	N/A	Malignant melanoma of left lower limb, including hip
C43.8	N/A	N/A	Malignant melanoma of overlapping sites of skin
C43.9	N/A	N/A	Malignant melanoma of skin, unspecified
D03.0	N/A	N/A	Melanoma in situ of lip
D03.10	N/A	N/A	Melanoma in situ of unspecified eyelid, including canthus
D03.11	N/A	N/A	Melanoma in situ of right eyelid, including canthus
D03.12	N/A	N/A	Melanoma in situ of left eyelid, including canthus
D03.20	N/A	N/A	Melanoma in situ of unspecified ear and external auricular canal
D03.21	N/A	N/A	Melanoma in situ of right ear and external auricular canal
D03.22	N/A	N/A	Melanoma in situ of left ear and external auricular canal
D03.30	N/A	N/A	Melanoma in situ of unspecified part of face
D03.39	N/A	N/A	Melanoma in situ of other parts of face
D03.4	N/A	N/A	Melanoma in situ of scalp and neck
D03.51	N/A	N/A	Melanoma in situ of anal skin
D03.52	N/A	N/A	Melanoma in situ of breast (skin) (soft tissue)
D03.59	N/A	N/A	Melanoma in situ of other part of trunk
D03.60	N/A	N/A	Melanoma in situ of unspecified upper limb, including shoulder
D03.61	N/A	N/A	Melanoma in situ of right upper limb, including shoulder
D03.62	N/A	N/A	Melanoma in situ of left upper limb, including shoulder
D03.70	N/A	N/A	Melanoma in situ of unspecified lower limb, including hip
D03.71	N/A	N/A	Melanoma in situ of right lower limb, including hip
D03.72	N/A	N/A	Melanoma in situ of left lower limb, including hip
D03.8	N/A	N/A	Melanoma in situ of other sites
D03.9	N/A	N/A	Melanoma in situ, 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/ACOThis measure can be submitted via Group Practice Reporting Option, or GPRO Web Interface.
SurveyThis measure can be submitted/collected via a Certified Survey Vendor.

More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.

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PQRS Measure

CPT Codes

ICD9 Codes

ICD10CM Codes