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PQRS Measure

 Report via: Claim, Registry

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
19125N/AN/AExcision of breast lesion identified by preoperative placement of radiological marker, open; single lesion
19301N/AN/AMastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
19302N/AN/AMastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy

HCPCS Codes

CodeModifierPOSDescription
G8872N/AN/AExcised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8873N/AN/APatients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
G8874N/AN/AExcised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion

ICD9 Codes

CodeModifierPOSDescription
174.0N/AN/AMalignant neoplasm of nipple and areola of female breast
174.1N/AN/AMalignant neoplasm of central portion of female breast
174.2N/AN/AMalignant neoplasm of upper-inner quadrant of female breast
174.3N/AN/AMalignant neoplasm of lower-inner quadrant of female breast
174.4N/AN/AMalignant neoplasm of upper-outer quadrant of female breast
174.5N/AN/AMalignant neoplasm of lower-outer quadrant of female breast
174.6N/AN/AMalignant neoplasm of axillary tail of female breast
174.8N/AN/AMalignant neoplasm of other specified sites of female breast
174.9N/AN/AMalignant neoplasm of breast (female), unspecified
175.0N/AN/AMalignant neoplasm of nipple and areola of male breast
175.9N/AN/AMalignant neoplasm of other and unspecified sites of male breast
198.81N/AN/ASecondary malignant neoplasm of breast
217N/AN/ABenign neoplasm of breast
239.3N/AN/ANeoplasm of unspecified nature of breast
610.0N/AN/ASolitary cyst of breast
610.1N/AN/ADiffuse cystic mastopathy
610.2N/AN/AFibroadenosis of breast
610.3N/AN/AFibrosclerosis of breast
610.4N/AN/AMammary duct ectasia
610.8N/AN/AOther specified benign mammary dysplasias
610.9N/AN/ABenign mammary dysplasia, unspecified
611.0N/AN/AInflammatory disease of breast
611.1N/AN/AHypertrophy of breast
611.2N/AN/AFissure of nipple
611.3N/AN/AFat necrosis of breast
611.4N/AN/AAtrophy of breast
611.5N/AN/AGalactocele
611.6N/AN/AGalactorrhea not associated with childbirth
611.71N/AN/AMastodynia
611.72N/AN/ALump or mass in breast
611.79N/AN/AOther signs and symptoms in breast
611.81N/AN/APtosis of breast
611.82N/AN/AHypoplasia of breast
611.83N/AN/ACapsular contracture of breast implant
611.89N/AN/AOther specified disorders of breast
611.9N/AN/AUnspecified breast disorder
793.80N/AN/AAbnormal mammogram, unspecified
793.81N/AN/AMammographic microcalcification
793.82N/AN/AInconclusive mammogram
793.89N/AN/AOther (abnormal) findings on radiological examination of breast

ICD10CM Codes

CodeModifierPOSDescription
C50.011N/AN/AMalignant neoplasm of nipple and areola, right female breast
C50.012N/AN/AMalignant neoplasm of nipple and areola, left female breast
C50.019N/AN/AMalignant neoplasm of nipple and areola, unspecified female breast
C50.021N/AN/AMalignant neoplasm of nipple and areola, right male breast
C50.022N/AN/AMalignant neoplasm of nipple and areola, left male breast
C50.029N/AN/AMalignant neoplasm of nipple and areola, unspecified male breast
C50.111N/AN/AMalignant neoplasm of central portion of right female breast
C50.112N/AN/AMalignant neoplasm of central portion of left female breast
C50.119N/AN/AMalignant neoplasm of central portion of unspecified female breast
C50.121N/AN/AMalignant neoplasm of central portion of right male breast
C50.122N/AN/AMalignant neoplasm of central portion of left male breast
C50.129N/AN/AMalignant neoplasm of central portion of unspecified male breast
C50.211N/AN/AMalignant neoplasm of upper-inner quadrant of right female breast
C50.212N/AN/AMalignant neoplasm of upper-inner quadrant of left female breast
C50.219N/AN/AMalignant neoplasm of upper-inner quadrant of unspecified female breast
C50.221N/AN/AMalignant neoplasm of upper-inner quadrant of right male breast
C50.222N/AN/AMalignant neoplasm of upper-inner quadrant of left male breast
C50.229N/AN/AMalignant neoplasm of upper-inner quadrant of unspecified male breast
C50.311N/AN/AMalignant neoplasm of lower-inner quadrant of right female breast
C50.312N/AN/AMalignant neoplasm of lower-inner quadrant of left female breast
C50.319N/AN/AMalignant neoplasm of lower-inner quadrant of unspecified female breast
C50.321N/AN/AMalignant neoplasm of lower-inner quadrant of right male breast
C50.322N/AN/AMalignant neoplasm of lower-inner quadrant of left male breast
C50.329N/AN/AMalignant neoplasm of lower-inner quadrant of unspecified male breast
C50.411N/AN/AMalignant neoplasm of upper-outer quadrant of right female breast
C50.412N/AN/AMalignant neoplasm of upper-outer quadrant of left female breast
C50.419N/AN/AMalignant neoplasm of upper-outer quadrant of unspecified female breast
C50.421N/AN/AMalignant neoplasm of upper-outer quadrant of right male breast
C50.422N/AN/AMalignant neoplasm of upper-outer quadrant of left male breast
C50.429N/AN/AMalignant neoplasm of upper-outer quadrant of unspecified male breast
C50.511N/AN/AMalignant neoplasm of lower-outer quadrant of right female breast
C50.512N/AN/AMalignant neoplasm of lower-outer quadrant of left female breast
C50.519N/AN/AMalignant neoplasm of lower-outer quadrant of unspecified female breast
C50.521N/AN/AMalignant neoplasm of lower-outer quadrant of right male breast
C50.522N/AN/AMalignant neoplasm of lower-outer quadrant of left male breast
C50.529N/AN/AMalignant neoplasm of lower-outer quadrant of unspecified male breast
C50.611N/AN/AMalignant neoplasm of axillary tail of right female breast
C50.612N/AN/AMalignant neoplasm of axillary tail of left female breast
C50.619N/AN/AMalignant neoplasm of axillary tail of unspecified female breast
C50.621N/AN/AMalignant neoplasm of axillary tail of right male breast
C50.622N/AN/AMalignant neoplasm of axillary tail of left male breast
C50.629N/AN/AMalignant neoplasm of axillary tail of unspecified male breast
C50.811N/AN/AMalignant neoplasm of overlapping sites of right female breast
C50.812N/AN/AMalignant neoplasm of overlapping sites of left female breast
C50.819N/AN/AMalignant neoplasm of overlapping sites of unspecified female breast
C50.821N/AN/AMalignant neoplasm of overlapping sites of right male breast
C50.822N/AN/AMalignant neoplasm of overlapping sites of left male breast
C50.829N/AN/AMalignant neoplasm of overlapping sites of unspecified male breast
C50.911N/AN/AMalignant neoplasm of unspecified site of right female breast
C50.912N/AN/AMalignant neoplasm of unspecified site of left female breast
C50.919N/AN/AMalignant neoplasm of unspecified site of unspecified female breast
C50.921N/AN/AMalignant neoplasm of unspecified site of right male breast
C50.922N/AN/AMalignant neoplasm of unspecified site of left male breast
C50.929N/AN/AMalignant neoplasm of unspecified site of unspecified male breast
C79.81N/AN/ASecondary malignant neoplasm of breast
D24.1N/AN/ABenign neoplasm of right breast
D24.2N/AN/ABenign neoplasm of left breast
D24.9N/AN/ABenign neoplasm of unspecified breast
D49.3N/AN/ANeoplasm of unspecified behavior of breast
N60.01N/AN/ASolitary cyst of right breast
N60.02N/AN/ASolitary cyst of left breast
N60.09N/AN/ASolitary cyst of unspecified breast
N60.11N/AN/ADiffuse cystic mastopathy of right breast
N60.12N/AN/ADiffuse cystic mastopathy of left breast
N60.19N/AN/ADiffuse cystic mastopathy of unspecified breast
N60.21N/AN/AFibroadenosis of right breast
N60.22N/AN/AFibroadenosis of left breast
N60.29N/AN/AFibroadenosis of unspecified breast
N60.31N/AN/AFibrosclerosis of right breast
N60.32N/AN/AFibrosclerosis of left breast
N60.39N/AN/AFibrosclerosis of unspecified breast
N60.41N/AN/AMammary duct ectasia of right breast
N60.42N/AN/AMammary duct ectasia of left breast
N60.49N/AN/AMammary duct ectasia of unspecified breast
N60.81N/AN/AOther benign mammary dysplasias of right breast
N60.82N/AN/AOther benign mammary dysplasias of left breast
N60.89N/AN/AOther benign mammary dysplasias of unspecified breast
N60.91N/AN/AUnspecified benign mammary dysplasia of right breast
N60.92N/AN/AUnspecified benign mammary dysplasia of left breast
N60.99N/AN/AUnspecified benign mammary dysplasia of unspecified breast
N61N/AN/AInflammatory disorders of breast
N62N/AN/AHypertrophy of breast
N64.0N/AN/AFissure and fistula of nipple
N64.1N/AN/AFat necrosis of breast
N64.2N/AN/AAtrophy of breast
N64.89N/AN/AOther specified disorders of breast
N64.3N/AN/AGalactorrhea not associated with childbirth
N64.4N/AN/AMastodynia
N63N/AN/AUnspecified lump in breast
N64.51N/AN/AInduration of breast
N64.52N/AN/ANipple discharge
N64.53N/AN/ARetraction of nipple
N64.59N/AN/AOther signs and symptoms in breast
N64.81N/AN/APtosis of breast
N64.82N/AN/AHypoplasia of breast
T85.44N/AN/A
T85.44XAN/AN/ACapsular contracture of breast implant, initial encounter
T85.44XDN/AN/ACapsular contracture of breast implant, subsequent encounter
T85.44XSN/AN/ACapsular contracture of breast implant, sequela
N64.9N/AN/ADisorder of breast, unspecified
R92.8N/AN/AOther abnormal and inconclusive findings on diagnostic imaging of breast
R92.0N/AN/AMammographic microcalcification found on diagnostic imaging of breast
R92.1N/AN/AMammographic calcification found on diagnostic imaging of breast
R92.2N/AN/AInconclusive mammogram
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.

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