PQRS Measure
This measure may be submitted via Registry only
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 11600 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less | ||
| 11601 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm | ||
| 11602 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm | ||
| 11603 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm | ||
| 11604 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm | ||
| 11606 | Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm | ||
| 11620 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less | ||
| 11621 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm | ||
| 11622 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm | ||
| 11623 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm | ||
| 11624 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm | ||
| 11626 | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm | ||
| 11640 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less | ||
| 11641 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm | ||
| 11642 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm | ||
| 11643 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm | ||
| 11644 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm | ||
| 11646 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm | ||
| 14000 | Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less | ||
| 14001 | Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm | ||
| 14020 | Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less | ||
| 14021 | Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm | ||
| 14040 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less | ||
| 14041 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm | ||
| 14060 | Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less | ||
| 14061 | Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm | ||
| 14301 | Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm | ||
| 17311 | Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks | ||
| 17313 | Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks | ||
| 5050F | 2P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
| 5050F | 3P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
| 5050F | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | ||
| 5050F | 8P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
| 99201 | Office 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. | ||
| 99202 | Office 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. | ||
| 99203 | Office 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. | ||
| 99204 | Office 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. | ||
| 99205 | Office 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. | ||
| 99212 | Office 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. | ||
| 99213 | Office 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. | ||
| 99214 | Office 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. | ||
| 99215 | Office 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. | ||
| 5050F | 2P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
| 5050F | 3P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
| 5050F | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | ||
| 5050F | 8P | Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (ML) | |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| C43.0 | Malignant melanoma of lip | ||
| C43.10 | Malignant melanoma of unspecified eyelid, including canthus | ||
| C43.11 | Malignant melanoma of right eyelid, including canthus | ||
| C43.12 | Malignant melanoma of left eyelid, including canthus | ||
| C43.20 | Malignant melanoma of unspecified ear and external auricular canal | ||
| C43.21 | Malignant melanoma of right ear and external auricular canal | ||
| C43.22 | Malignant melanoma of left ear and external auricular canal | ||
| C43.30 | Malignant melanoma of unspecified part of face | ||
| C43.31 | Malignant melanoma of nose | ||
| C43.39 | Malignant melanoma of other parts of face | ||
| C43.4 | Malignant melanoma of scalp and neck | ||
| C43.51 | Malignant melanoma of anal skin | ||
| C43.52 | Malignant melanoma of skin of breast | ||
| C43.59 | Malignant melanoma of other part of trunk | ||
| C43.60 | Malignant melanoma of unspecified upper limb, including shoulder | ||
| C43.61 | Malignant melanoma of right upper limb, including shoulder | ||
| C43.62 | Malignant melanoma of left upper limb, including shoulder | ||
| C43.70 | Malignant melanoma of unspecified lower limb, including hip | ||
| C43.71 | Malignant melanoma of right lower limb, including hip | ||
| C43.72 | Malignant melanoma of left lower limb, including hip | ||
| C43.8 | Malignant melanoma of overlapping sites of skin | ||
| C43.9 | Malignant melanoma of skin, unspecified | ||
| D03.0 | Melanoma in situ of lip | ||
| D03.10 | Melanoma in situ of unspecified eyelid, including canthus | ||
| D03.11 | Melanoma in situ of right eyelid, including canthus | ||
| D03.12 | Melanoma in situ of left eyelid, including canthus | ||
| D03.20 | Melanoma in situ of unspecified ear and external auricular canal | ||
| D03.21 | Melanoma in situ of right ear and external auricular canal | ||
| D03.22 | Melanoma in situ of left ear and external auricular canal | ||
| D03.30 | Melanoma in situ of unspecified part of face | ||
| D03.39 | Melanoma in situ of other parts of face | ||
| D03.4 | Melanoma in situ of scalp and neck | ||
| D03.51 | Melanoma in situ of anal skin | ||
| D03.52 | Melanoma in situ of breast (skin) (soft tissue) | ||
| D03.59 | Melanoma in situ of other part of trunk | ||
| D03.60 | Melanoma in situ of unspecified upper limb, including shoulder | ||
| D03.61 | Melanoma in situ of right upper limb, including shoulder | ||
| D03.62 | Melanoma in situ of left upper limb, including shoulder | ||
| D03.70 | Melanoma in situ of unspecified lower limb, including hip | ||
| D03.71 | Melanoma in situ of right lower limb, including hip | ||
| D03.72 | Melanoma in situ of left lower limb, including hip | ||
| D03.8 | Melanoma in situ of other sites | ||
| D03.9 | Melanoma in situ, unspecified | ||
| C43.0 | Malignant melanoma of lip | ||
| C43.10 | Malignant melanoma of unspecified eyelid, including canthus | ||
| C43.11 | Malignant melanoma of right eyelid, including canthus | ||
| C43.12 | Malignant melanoma of left eyelid, including canthus | ||
| C43.20 | Malignant melanoma of unspecified ear and external auricular canal | ||
| C43.21 | Malignant melanoma of right ear and external auricular canal | ||
| C43.22 | Malignant melanoma of left ear and external auricular canal | ||
| C43.30 | Malignant melanoma of unspecified part of face | ||
| C43.31 | Malignant melanoma of nose | ||
| C43.39 | Malignant melanoma of other parts of face | ||
| C43.4 | Malignant melanoma of scalp and neck | ||
| C43.51 | Malignant melanoma of anal skin | ||
| C43.52 | Malignant melanoma of skin of breast | ||
| C43.59 | Malignant melanoma of other part of trunk | ||
| C43.60 | Malignant melanoma of unspecified upper limb, including shoulder | ||
| C43.61 | Malignant melanoma of right upper limb, including shoulder | ||
| C43.62 | Malignant melanoma of left upper limb, including shoulder | ||
| C43.70 | Malignant melanoma of unspecified lower limb, including hip | ||
| C43.71 | Malignant melanoma of right lower limb, including hip | ||
| C43.72 | Malignant melanoma of left lower limb, including hip | ||
| C43.8 | Malignant melanoma of overlapping sites of skin | ||
| C43.9 | Malignant melanoma of skin, unspecified | ||
| D03.0 | Melanoma in situ of lip | ||
| D03.10 | Melanoma in situ of unspecified eyelid, including canthus | ||
| D03.11 | Melanoma in situ of right eyelid, including canthus | ||
| D03.12 | Melanoma in situ of left eyelid, including canthus | ||
| D03.20 | Melanoma in situ of unspecified ear and external auricular canal | ||
| D03.21 | Melanoma in situ of right ear and external auricular canal | ||
| D03.22 | Melanoma in situ of left ear and external auricular canal | ||
| D03.30 | Melanoma in situ of unspecified part of face | ||
| D03.39 | Melanoma in situ of other parts of face | ||
| D03.4 | Melanoma in situ of scalp and neck | ||
| D03.51 | Melanoma in situ of anal skin | ||
| D03.52 | Melanoma in situ of breast (skin) (soft tissue) | ||
| D03.59 | Melanoma in situ of other part of trunk | ||
| D03.60 | Melanoma in situ of unspecified upper limb, including shoulder | ||
| D03.61 | Melanoma in situ of right upper limb, including shoulder | ||
| D03.62 | Melanoma in situ of left upper limb, including shoulder | ||
| D03.70 | Melanoma in situ of unspecified lower limb, including hip | ||
| D03.71 | Melanoma in situ of right lower limb, including hip | ||
| D03.72 | Melanoma in situ of left lower limb, including hip | ||
| D03.8 | Melanoma in situ of other sites | ||
| D03.9 | Melanoma in situ, unspecified | ||
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.
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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