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PQRS Measure

#51Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
 Report via: Claim, Registry, Measure Group
 This measure is can be reported as part of the following groups:
 Chronic Obstructive Pulmonary Disease (COPD) Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
99201N/AN/AOffice 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.
99202N/AN/AOffice 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.
99203N/AN/AOffice 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.
99204N/AN/AOffice 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.
99205N/AN/AOffice 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.
99212N/AN/AOffice 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.
99213N/AN/AOffice 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.
99214N/AN/AOffice 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.
99215N/AN/AOffice 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.
3023F1PN/ASpirometry results documented and reviewed (COPD)
3023F2PN/ASpirometry results documented and reviewed (COPD)
3023F3PN/ASpirometry results documented and reviewed (COPD)
3023F8PN/ASpirometry results documented and reviewed (COPD)
3023FN/AN/ASpirometry results documented and reviewed (COPD)
3023F8PN/ASpirometry results documented and reviewed (COPD)
3023FN/AN/ASpirometry results documented and reviewed (COPD)

ICD9 Codes

CodeModifierPOSDescription
491.0N/AN/ASimple chronic bronchitis
491.1N/AN/AMucopurulent chronic bronchitis
491.20N/AN/AObstructive chronic bronchitis without exacerbation
491.21N/AN/AObstructive chronic bronchitis with (acute) exacerbation
491.22N/AN/AObstructive chronic bronchitis with acute bronchitis
491.8N/AN/AOther chronic bronchitis
491.9N/AN/AUnspecified chronic bronchitis
492.0N/AN/AEmphysematous bleb
492.8N/AN/AOther emphysema
496N/AN/AChronic airway obstruction, not elsewhere classified
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 IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.

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