PQRS Measure
#194Oncology: Cancer Stage Documented
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 77261 | N/A | N/A | Therapeutic radiology treatment planning; simple |
| 77262 | N/A | N/A | Therapeutic radiology treatment planning; intermediate |
| 77263 | N/A | N/A | Therapeutic radiology treatment planning; complex |
| 99201 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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 | N/A | N/A | 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. |
| 3300F | N/A | N/A | American Joint Committee on Cancer (AJCC) stage documented and reviewed (ONC) |
| 3301F | 8P | N/A | Cancer stage documented in medical record as metastatic and reviewed (ONC) |
| 3301F | N/A | N/A | Cancer stage documented in medical record as metastatic and reviewed (ONC) |
| 3300F | N/A | N/A | American Joint Committee on Cancer (AJCC) stage documented and reviewed (ONC) |
| 3301F | 8P | N/A | Cancer stage documented in medical record as metastatic and reviewed (ONC) |
| 3301F | N/A | N/A | Cancer stage documented in medical record as metastatic and reviewed (ONC) |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 153.0 | N/A | N/A | Malignant neoplasm of hepatic flexure |
| 153.1 | N/A | N/A | Malignant neoplasm of transverse colon |
| 153.2 | N/A | N/A | Malignant neoplasm of descending colon |
| 153.3 | N/A | N/A | Malignant neoplasm of sigmoid colon |
| 153.4 | N/A | N/A | Malignant neoplasm of cecum |
| 153.5 | N/A | N/A | Malignant neoplasm of appendix vermiformis |
| 153.6 | N/A | N/A | Malignant neoplasm of ascending colon |
| 153.7 | N/A | N/A | Malignant neoplasm of splenic flexure |
| 153.8 | N/A | N/A | Malignant neoplasm of other specified sites of large intestine |
| 153.9 | N/A | N/A | Malignant neoplasm of colon, unspecified site |
| 154.0 | N/A | N/A | Malignant neoplasm of rectosigmoid junction |
| 154.1 | N/A | N/A | Malignant neoplasm of rectum |
| 154.2 | N/A | N/A | Malignant neoplasm of anal canal |
| 154.3 | N/A | N/A | Malignant neoplasm of anus, unspecified site |
| 154.8 | N/A | N/A | Malignant neoplasm of other sites of rectum, rectosigmoid junction, and anus |
| 174.0 | N/A | N/A | Malignant neoplasm of nipple and areola of female breast |
| 174.1 | N/A | N/A | Malignant neoplasm of central portion of female breast |
| 174.2 | N/A | N/A | Malignant neoplasm of upper-inner quadrant of female breast |
| 174.3 | N/A | N/A | Malignant neoplasm of lower-inner quadrant of female breast |
| 174.4 | N/A | N/A | Malignant neoplasm of upper-outer quadrant of female breast |
| 174.5 | N/A | N/A | Malignant neoplasm of lower-outer quadrant of female breast |
| 174.6 | N/A | N/A | Malignant neoplasm of axillary tail of female breast |
| 174.8 | N/A | N/A | Malignant neoplasm of other specified sites of female breast |
| 174.9 | N/A | N/A | Malignant neoplasm of breast (female), unspecified |
| V10.05 | N/A | N/A | Personal history of malignant neoplasm of large intestine |
| V10.06 | N/A | N/A | Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus |
| V10.3 | N/A | N/A | Personal history of malignant neoplasm of breast |
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.
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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