PQRS Measure
This measure may be submitted via Registry only
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 90957 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month |
| 90958 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month |
| 90959 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month |
| 90960 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month |
| 90961 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month |
| 90962 | N/A | N/A | End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month |
| 90966 | N/A | N/A | End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 20 years of age and older |
| 90970 | N/A | N/A | End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G9240 | N/A | N/A | Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated |
| G9265 | N/A | N/A | Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access |
| G9264 | N/A | N/A | Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons) |
| G9266 | N/A | N/A | Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 585.6 | N/A | N/A | End stage renal disease |
| V56.0 | N/A | N/A | Encounter for extracorporeal dialysis |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| N18.6 | N/A | N/A | End stage renal disease |
| Z49.31 | N/A | N/A | Encounter for adequacy testing for hemodialysis |
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.
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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