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PQRS Measure

#161HIV/AIDS: Adolescent and Adult Patients with HIV/AIDS Who Are Prescribed Potent Antiretroviral Therapy
 Report via: Registry, GPRO II, Measure Group
 This measure is can be reported as part of the following groups:
 HIV/AIDS Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
4276FPotent antiretroviral therapy prescribed (HIV)
3492FHistory of nadir CD4+ cell count <350 cells/mm3 (HIV)
3490FHistory of AIDS-defining condition (HIV)
3493FNo history of nadir CD4+ cell count <350 cells/mm3 and no history of AIDS-defining condition (HIV)
4276F8PPotent antiretroviral therapy prescribed (HIV)
99201Office 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.
99202Office 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.
99203Office 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.
99204Office 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.
99205Office 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.
99212Office 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.
99213Office 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.
99214Office 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.
99215Office 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.

ICD9 Codes

CodeModifierPOSDescription
042Human immunodeficiency virus [HIV] disease
079.53Human immunodeficiency virus, type 2 [HIV-2]
V08Asymptomatic human immunodeficiency virus [HIV] infection status
V22.0Supervision of normal first pregnancy
V22.1Supervision of other normal pregnancy
V22.2Pregnant state, incidental
V23.0Supervision of high-risk pregnancy with history of infertility
V23.1Supervision of high-risk pregnancy with history of trophoblastic disease
V23.2Supervision of high-risk pregnancy with history of abortion
V23.3Supervision of high-risk pregnancy with grand multiparity
V23.41Pregnancy with history of pre-term labor
V23.49Pregnancy with other poor obstetric history
V23.5Supervision of high-risk pregnancy with other poor reproductive history
V23.7Supervision of high-risk pregnancy with insufficient prenatal care
V23.81Supervision of high-risk pregnancy with elderly primigravida
V23.82Supervision of high-risk pregnancy with elderly multigravida
V23.83Supervision of high-risk pregnancy with young primigravida
V23.84Supervision of high-risk pregnancy with young multigravida
V23.89Supervision of other high-risk pregnancy
V23.9Supervision of unspecified high-risk pregnancy
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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