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PQRS Measure

 This measure may be submitted via Registry only

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
99221N/AN/AInitial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
99222N/AN/AInitial hospital inpatient or observation care, per day, for the evaluation and management of a 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, 55 minutes must be met or exceeded.
99223N/AN/AInitial hospital inpatient or observation care, per day, for the evaluation and management of a 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, 75 minutes must be met or exceeded.
99291N/AN/ACritical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes

HCPCS Codes

CodeModifierPOSDescription
G8600N/AN/AIv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well
G8601N/AN/AIv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention)
G8602N/AN/AIv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well, reason not given

ICD9 Codes

CodeModifierPOSDescription
433.01N/AN/AOcclusion and stenosis of basilar artery with cerebral infarction
433.10N/AN/AOcclusion and stenosis of carotid artery without mention of cerebral infarction
433.11N/AN/AOcclusion and stenosis of carotid artery with cerebral infarction
433.21N/AN/AOcclusion and stenosis of vertebral artery with cerebral infarction
433.31N/AN/AOcclusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction
433.81N/AN/AOcclusion and stenosis of other specified precerebral artery with cerebral infarction
433.91N/AN/AOcclusion and stenosis of unspecified precerebral artery with cerebral infarction
434.00N/AN/ACerebral thrombosis without mention of cerebral infarction
434.01N/AN/ACerebral thrombosis with cerebral infarction
434.11N/AN/ACerebral embolism with cerebral infarction
434.91N/AN/ACerebral artery occlusion, unspecified with cerebral infarction
436N/AN/AAcute, but ill-defined, cerebrovascular disease

ICD10CM Codes

CodeModifierPOSDescription
I63.111N/AN/ACerebral infarction due to embolism of right vertebral artery
I63.112N/AN/ACerebral infarction due to embolism of left vertebral artery
I63.119N/AN/ACerebral infarction due to embolism of unspecified vertebral artery
I63.139N/AN/ACerebral infarction due to embolism of unspecified carotid artery
I63.19N/AN/ACerebral infarction due to embolism of other precerebral artery
I63.20N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
I63.219N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
I63.22N/AN/ACerebral infarction due to unspecified occlusion or stenosis of basilar artery
I63.231N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.239N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
I63.30N/AN/ACerebral infarction due to thrombosis of unspecified cerebral artery
I63.40N/AN/ACerebral infarction due to embolism of unspecified cerebral artery
I63.50N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.59N/AN/ACerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I65.29N/AN/AOcclusion and stenosis of unspecified carotid artery
I66.02N/AN/AOcclusion and stenosis of left middle cerebral artery
I66.03N/AN/AOcclusion and stenosis of bilateral middle cerebral arteries
I66.09N/AN/AOcclusion and stenosis of unspecified middle cerebral artery
I66.19N/AN/AOcclusion and stenosis of unspecified anterior cerebral artery
I66.29N/AN/AOcclusion and stenosis of unspecified posterior cerebral artery
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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