PQRS Measure
#194Oncology: Cancer Stage Documented
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 3300F | American Joint Committee on Cancer (AJCC) stage documented and reviewed (ONC) | ||
| 3301F | Cancer stage documented in medical record as metastatic and reviewed (ONC) | ||
| 3301F | 8P | Cancer stage documented in medical record as metastatic and reviewed (ONC) | |
| 77261 | Therapeutic radiology treatment planning; simple | ||
| 77262 | Therapeutic radiology treatment planning; intermediate | ||
| 77263 | Therapeutic radiology treatment planning; complex | ||
| 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. | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 153.0 | Malignant neoplasm of hepatic flexure | ||
| 153.1 | Malignant neoplasm of transverse colon | ||
| 153.2 | Malignant neoplasm of descending colon | ||
| 153.3 | Malignant neoplasm of sigmoid colon | ||
| 153.4 | Malignant neoplasm of cecum | ||
| 153.5 | Malignant neoplasm of appendix vermiformis | ||
| 153.6 | Malignant neoplasm of ascending colon | ||
| 153.7 | Malignant neoplasm of splenic flexure | ||
| 153.8 | Malignant neoplasm of other specified sites of large intestine | ||
| 153.9 | Malignant neoplasm of colon, unspecified site | ||
| 154.0 | Malignant neoplasm of rectosigmoid junction | ||
| 154.1 | Malignant neoplasm of rectum | ||
| 154.2 | Malignant neoplasm of anal canal | ||
| 154.3 | Malignant neoplasm of anus, unspecified site | ||
| 154.8 | Malignant neoplasm of other sites of rectum, rectosigmoid junction, and anus | ||
| 174.0 | Malignant neoplasm of nipple and areola of female breast | ||
| 174.1 | Malignant neoplasm of central portion of female breast | ||
| 174.2 | Malignant neoplasm of upper-inner quadrant of female breast | ||
| 174.3 | Malignant neoplasm of lower-inner quadrant of female breast | ||
| 174.4 | Malignant neoplasm of upper-outer quadrant of female breast | ||
| 174.5 | Malignant neoplasm of lower-outer quadrant of female breast | ||
| 174.6 | Malignant neoplasm of axillary tail of female breast | ||
| 174.8 | Malignant neoplasm of other specified sites of female breast | ||
| 174.9 | Malignant neoplasm of breast (female), unspecified | ||
| V10.3 | Personal history of malignant neoplasm of breast | ||
| V10.05 | Personal history of malignant neoplasm of large intestine | ||
| V10.06 | Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus | ||
Legend:
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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