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

PQRS Measure

 Report via: Claim, Registry, EHR, GPRO/ACO, Measure Group
 This measure is can be reported as part of the following groups:
 Cardiovascular Prevention Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
99201Office 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.
99202Office 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.
99203Office 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.
99204Office 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.
99205Office 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.
99212Office 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.
99213Office 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.
99214Office 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.
99215Office 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.
99341Home or residence 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.
99342Home or residence 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.
99343Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. 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 of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344Home or residence 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, 60 minutes must be met or exceeded.
99345Home or residence 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, 75 minutes must be met or exceeded.
99347Home or residence 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, 20 minutes must be met or exceeded.
99348Home or residence 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, 30 minutes must be met or exceeded.
99349Home or residence 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, 40 minutes must be met or exceeded.
99350Home or residence 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, 60 minutes must be met or exceeded.
33511Coronary artery bypass, vein only; 2 coronary venous grafts
33512Coronary artery bypass, vein only; 3 coronary venous grafts
33513Coronary artery bypass, vein only; 4 coronary venous grafts
33514Coronary artery bypass, vein only; 5 coronary venous grafts
33516Coronary artery bypass, vein only; 6 or more coronary venous grafts
33517Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure)
33518Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure)
33519Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (List separately in addition to code for primary procedure)
33521Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure)
33522Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure)
33523Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure)
33533Coronary artery bypass, using arterial graft(s); single arterial graft
33534Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts
33535Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts
33536Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts
92920Percutaneous transluminal coronary angioplasty; single major coronary artery or branch
92924Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch
92928Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
92933Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
92937Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
92941Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
92943Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel

HCPCS Codes

CodeModifierPOSDescription
G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G8598Aspirin or another antiplatelet therapy used
G8598Aspirin or another antiplatelet therapy used
G8599Aspirin or another antiplatelet therapy not used, reason not given
G8599Aspirin or another antiplatelet therapy not used, reason not given

ICD10CM Codes

CodeModifierPOSDescription
I20.0Unstable angina
I20.1Angina pectoris with documented spasm
I20.8Other forms of angina pectoris
I20.9Angina pectoris, unspecified
I24.0Acute coronary thrombosis not resulting in myocardial infarction
I24.1Dressler's syndrome
I24.8Other forms of acute ischemic heart disease
I24.9Acute ischemic heart disease, unspecified
I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.5Ischemic cardiomyopathy
I25.6Silent myocardial ischemia
I25.700Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.708Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.728Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.738Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
I25.758Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.768Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.798Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.810Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82Chronic total occlusion of coronary artery
I25.84Coronary atherosclerosis due to calcified coronary lesion
I25.89Other forms of chronic ischemic heart disease
I25.9Chronic ischemic heart disease, unspecified
I63.00Cerebral infarction due to thrombosis of unspecified precerebral artery
I63.011Cerebral infarction due to thrombosis of right vertebral artery
I63.012Cerebral infarction due to thrombosis of left vertebral artery
I63.019Cerebral infarction due to thrombosis of unspecified vertebral artery
I63.02Cerebral infarction due to thrombosis of basilar artery
I63.031Cerebral infarction due to thrombosis of right carotid artery
I63.032Cerebral infarction due to thrombosis of left carotid artery
I63.039Cerebral infarction due to thrombosis of unspecified carotid artery
I63.09Cerebral infarction due to thrombosis of other precerebral artery
I63.10Cerebral infarction due to embolism of unspecified precerebral artery
I63.111Cerebral infarction due to embolism of right vertebral artery
I63.112Cerebral infarction due to embolism of left vertebral artery
I63.119Cerebral infarction due to embolism of unspecified vertebral artery
I63.12Cerebral infarction due to embolism of basilar artery
I63.131Cerebral infarction due to embolism of right carotid artery
I63.132Cerebral infarction due to embolism of left carotid artery
I63.139Cerebral infarction due to embolism of unspecified carotid artery
I63.19Cerebral infarction due to embolism of other precerebral artery
I63.20Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
I63.211Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery
I63.212Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery
I63.219Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
I63.22Cerebral infarction due to unspecified occlusion or stenosis of basilar artery
I63.231Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.239Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
I63.29Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries
I63.30Cerebral infarction due to thrombosis of unspecified cerebral artery
I63.311Cerebral infarction due to thrombosis of right middle cerebral artery
I63.312Cerebral infarction due to thrombosis of left middle cerebral artery
I63.319Cerebral infarction due to thrombosis of unspecified middle cerebral artery
I63.321Cerebral infarction due to thrombosis of right anterior cerebral artery
I63.322Cerebral infarction due to thrombosis of left anterior cerebral artery
I63.329Cerebral infarction due to thrombosis of unspecified anterior cerebral artery
I63.331Cerebral infarction due to thrombosis of right posterior cerebral artery
I63.332Cerebral infarction due to thrombosis of left posterior cerebral artery
I63.339Cerebral infarction due to thrombosis of unspecified posterior cerebral artery
I63.341Cerebral infarction due to thrombosis of right cerebellar artery
I63.342Cerebral infarction due to thrombosis of left cerebellar artery
I63.349Cerebral infarction due to thrombosis of unspecified cerebellar artery
I63.39Cerebral infarction due to thrombosis of other cerebral artery
I63.40Cerebral infarction due to embolism of unspecified cerebral artery
I63.411Cerebral infarction due to embolism of right middle cerebral artery
I63.412Cerebral infarction due to embolism of left middle cerebral artery
I63.419Cerebral infarction due to embolism of unspecified middle cerebral artery
I63.421Cerebral infarction due to embolism of right anterior cerebral artery
I63.422Cerebral infarction due to embolism of left anterior cerebral artery
I63.429Cerebral infarction due to embolism of unspecified anterior cerebral artery
I63.431Cerebral infarction due to embolism of right posterior cerebral artery
I63.432Cerebral infarction due to embolism of left posterior cerebral artery
I63.439Cerebral infarction due to embolism of unspecified posterior cerebral artery
I63.441Cerebral infarction due to embolism of right cerebellar artery
I63.442Cerebral infarction due to embolism of left cerebellar artery
I63.449Cerebral infarction due to embolism of unspecified cerebellar artery
I63.49Cerebral infarction due to embolism of other cerebral artery
I63.50Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.511Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery
I63.512Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery
I63.519Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery
I63.521Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery
I63.522Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery
I63.529Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery
I63.531Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
I63.532Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery
I63.539Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery
I63.541Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery
I63.542Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery
I63.549Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery
I63.59Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I63.6Cerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.8Other cerebral infarction
I63.9Cerebral infarction, unspecified
I65.01Occlusion and stenosis of right vertebral artery
I65.02Occlusion and stenosis of left vertebral artery
I65.03Occlusion and stenosis of bilateral vertebral arteries
I65.09Occlusion and stenosis of unspecified vertebral artery
I65.1Occlusion and stenosis of basilar artery
I65.21Occlusion and stenosis of right carotid artery
I65.22Occlusion and stenosis of left carotid artery
I65.23Occlusion and stenosis of bilateral carotid arteries
I65.29Occlusion and stenosis of unspecified carotid artery
I65.8Occlusion and stenosis of other precerebral arteries
I65.9Occlusion and stenosis of unspecified precerebral artery
I66.01Occlusion and stenosis of right middle cerebral artery
I66.02Occlusion and stenosis of left middle cerebral artery
I66.03Occlusion and stenosis of bilateral middle cerebral arteries
I66.09Occlusion and stenosis of unspecified middle cerebral artery
I66.11Occlusion and stenosis of right anterior cerebral artery
I66.12Occlusion and stenosis of left anterior cerebral artery
I66.13Occlusion and stenosis of bilateral anterior cerebral arteries
I66.19Occlusion and stenosis of unspecified anterior cerebral artery
I66.21Occlusion and stenosis of right posterior cerebral artery
I66.22Occlusion and stenosis of left posterior cerebral artery
I66.23Occlusion and stenosis of bilateral posterior cerebral arteries
I66.29Occlusion and stenosis of unspecified posterior cerebral artery
I66.3Occlusion and stenosis of cerebellar arteries
I66.8Occlusion and stenosis of other cerebral arteries
I66.9Occlusion and stenosis of unspecified cerebral artery
I70.1Atherosclerosis of renal artery
I70.201Unspecified atherosclerosis of native arteries of extremities, right leg
I70.202Unspecified atherosclerosis of native arteries of extremities, left leg
I70.203Unspecified atherosclerosis of native arteries of extremities, bilateral legs
I70.208Unspecified atherosclerosis of native arteries of extremities, other extremity
I70.209Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
I70.211Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
I70.212Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
I70.218Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
I70.219Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity
I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
I70.222Atherosclerosis of native arteries of extremities with rest pain, left leg
I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
I70.228Atherosclerosis of native arteries of extremities with rest pain, other extremity
I70.229Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
I70.232Atherosclerosis of native arteries of right leg with ulceration of calf
I70.233Atherosclerosis of native arteries of right leg with ulceration of ankle
I70.234Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
I70.235Atherosclerosis of native arteries of right leg with ulceration of other part of foot
I70.238Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
I70.239Atherosclerosis of native arteries of right leg with ulceration of unspecified site
I70.241Atherosclerosis of native arteries of left leg with ulceration of thigh
I70.242Atherosclerosis of native arteries of left leg with ulceration of calf
I70.243Atherosclerosis of native arteries of left leg with ulceration of ankle
I70.244Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot
I70.245Atherosclerosis of native arteries of left leg with ulceration of other part of foot
I70.248Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg
I70.249Atherosclerosis of native arteries of left leg with ulceration of unspecified site
I70.25Atherosclerosis of native arteries of other extremities with ulceration
I70.261Atherosclerosis of native arteries of extremities with gangrene, right leg
I70.262Atherosclerosis of native arteries of extremities with gangrene, left leg
I70.263Atherosclerosis of native arteries of extremities with gangrene, bilateral legs
I70.268Atherosclerosis of native arteries of extremities with gangrene, other extremity
I70.269Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity
I70.291Other atherosclerosis of native arteries of extremities, right leg
I70.292Other atherosclerosis of native arteries of extremities, left leg
I70.293Other atherosclerosis of native arteries of extremities, bilateral legs
I70.298Other atherosclerosis of native arteries of extremities, other extremity
I70.299Other atherosclerosis of native arteries of extremities, unspecified extremity
I70.92Chronic total occlusion of artery of the extremities
I74.01Saddle embolus of abdominal aorta
I74.09Other arterial embolism and thrombosis of abdominal aorta
I74.10Embolism and thrombosis of unspecified parts of aorta
I74.11Embolism and thrombosis of thoracic aorta
I74.19Embolism and thrombosis of other parts of aorta
I74.2Embolism and thrombosis of arteries of the upper extremities
I74.3Embolism and thrombosis of arteries of the lower extremities
I74.4Embolism and thrombosis of arteries of extremities, unspecified
I74.5Embolism and thrombosis of iliac artery
I74.8Embolism and thrombosis of other arteries
I74.9Embolism and thrombosis of unspecified artery
I75.011Atheroembolism of right upper extremity
I75.012Atheroembolism of left upper extremity
I75.013Atheroembolism of bilateral upper extremities
I75.019Atheroembolism of unspecified upper extremity
I75.021Atheroembolism of right lower extremity
I75.022Atheroembolism of left lower extremity
I75.023Atheroembolism of bilateral lower extremities
I75.029Atheroembolism of unspecified lower extremity
I75.81Atheroembolism of kidney
I75.89Atheroembolism of other site
I21.01ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29ST elevation (STEMI) myocardial infarction involving other sites
I21.3ST elevation (STEMI) myocardial infarction of unspecified site
I21.4Non-ST elevation (NSTEMI) myocardial infarction
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).
GPROThis 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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