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PQRS Measure

#131Pain Assessment Prior to Initiation of Patient Therapy and Follow-Up
 Description  Data Collection Sheet  Coding Specifications Report via: Claim, Registry, GPRO II

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
90801Psychiatric diagnostic interview examination
90802Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication
96116Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour
96150Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
97001Physical therapy evaluation
97003Occupational therapy evaluation
98940Chiropractic manipulative treatment (CMT); spinal, 1-2 regions
98941Chiropractic manipulative treatment (CMT); spinal, 3-4 regions
98942Chiropractic manipulative treatment (CMT); spinal, 5 regions

HCPCS Codes

CodeModifierPOSDescription
G8440Documentation of pain assessment (including location, intensity and description) prior to initiation of therapy or documentation of the absence of pain as a result of assessment through discussion with the patient including the use of a standardized tool and a follow-up plan is documented
G8441No documentation of pain assessment (including location, intensity and description) prior to initiation of therapy
G8509Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given
G8442Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter
G8508Documentation of pain assessment (including location, intensity and description) prior to initiation of therapy or documentation of the absence of pain as a result of assessment through discussion with the patient including the use of a standardized tool; no documentation of a follow-up plan, patient not eligible
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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