PQRS Information

Year: 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007

PQRS Measure

#248Substance Use Disorders: Screening for Depression Among Patients with Substance Abuse or Dependence

Report via: Claim, Registry

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
90801	N/A	N/A	Psychiatric diagnostic interview examination
90802	N/A	N/A	Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication
90804	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient;
90805	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services
90806	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient;
90807	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services
90808	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient;
90809	N/A	N/A	Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient; with medical evaluation and management services
90810	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient;
90811	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services
90812	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient;
90813	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services
90814	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient;
90815	N/A	N/A	Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient; with medical evaluation and management services
90845	N/A	N/A	Psychoanalysis
90862	N/A	N/A	Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
96150	N/A	N/A	Health 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
96152	N/A	N/A	Health and behavior intervention, each 15 minutes, face-to-face; individual
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.
1220F	1P	N/A	Patient screened for depression (SUD)
1220F	8P	N/A	Patient screened for depression (SUD)
1220F	N/A	N/A	Patient screened for depression (SUD)
1220F	8P	N/A	Patient screened for depression (SUD)
1220F	N/A	N/A	Patient screened for depression (SUD)
ICD9 Codes
Code	Modifier	POS	Description
303.90	N/A	N/A	Other and unspecified alcohol dependence, unspecified
303.91	N/A	N/A	Other and unspecified alcohol dependence, continuous
303.92	N/A	N/A	Other and unspecified alcohol dependence, episodic
304.00	N/A	N/A	Opioid type dependence, unspecified
304.01	N/A	N/A	Opioid type dependence, continuous
304.02	N/A	N/A	Opioid type dependence, episodic
304.10	N/A	N/A	Sedative, hypnotic or anxiolytic dependence, unspecified
304.11	N/A	N/A	Sedative, hypnotic or anxiolytic dependence, continuous
304.12	N/A	N/A	Sedative, hypnotic or anxiolytic dependence, episodic
304.20	N/A	N/A	Cocaine dependence, unspecified
304.21	N/A	N/A	Cocaine dependence, continuous
304.22	N/A	N/A	Cocaine dependence, episodic
304.30	N/A	N/A	Cannabis dependence, unspecified
304.31	N/A	N/A	Cannabis dependence, continuous
304.32	N/A	N/A	Cannabis dependence, episodic
304.40	N/A	N/A	Amphetamine and other psychostimulant dependence, unspecified
304.41	N/A	N/A	Amphetamine and other psychostimulant dependence, continuous
304.42	N/A	N/A	Amphetamine and other psychostimulant dependence, episodic
304.50	N/A	N/A	Hallucinogen dependence, unspecified
304.51	N/A	N/A	Hallucinogen dependence, continuous
304.52	N/A	N/A	Hallucinogen dependence, episodic
304.60	N/A	N/A	Other specified drug dependence, unspecified
304.61	N/A	N/A	Other specified drug dependence, continuous
304.62	N/A	N/A	Other specified drug dependence, episodic
304.70	N/A	N/A	Combinations of opioid type drug with any other drug dependence, unspecified
304.71	N/A	N/A	Combinations of opioid type drug with any other drug dependence, continuous
304.72	N/A	N/A	Combinations of opioid type drug with any other drug dependence, episodic
304.80	N/A	N/A	Combinations of drug dependence excluding opioid type drug, unspecified
304.81	N/A	N/A	Combinations of drug dependence excluding opioid type drug, continuous
304.82	N/A	N/A	Combinations of drug dependence excluding opioid type drug, episodic
304.90	N/A	N/A	Unspecified drug dependence, unspecified
304.91	N/A	N/A	Unspecified drug dependence, continuous
304.92	N/A	N/A	Unspecified drug dependence, episodic
305.00	N/A	N/A	Alcohol abuse, unspecified
305.01	N/A	N/A	Alcohol abuse, continuous
305.02	N/A	N/A	Alcohol abuse, episodic
305.20	N/A	N/A	Cannabis abuse, unspecified
305.21	N/A	N/A	Cannabis abuse, continuous
305.22	N/A	N/A	Cannabis abuse, episodic
305.30	N/A	N/A	Hallucinogen abuse, unspecified
305.31	N/A	N/A	Hallucinogen abuse, continuous
305.32	N/A	N/A	Hallucinogen abuse, episodic
305.40	N/A	N/A	Sedative, hypnotic or anxiolytic abuse, unspecified
305.41	N/A	N/A	Sedative, hypnotic or anxiolytic abuse, continuous
305.42	N/A	N/A	Sedative, hypnotic or anxiolytic abuse, episodic
305.50	N/A	N/A	Opioid abuse, unspecified
305.51	N/A	N/A	Opioid abuse, continuous
305.52	N/A	N/A	Opioid abuse, episodic
305.60	N/A	N/A	Cocaine abuse, unspecified
305.61	N/A	N/A	Cocaine abuse, continuous
305.62	N/A	N/A	Cocaine abuse, episodic
305.70	N/A	N/A	Amphetamine or related acting sympathomimetic abuse, unspecified
305.71	N/A	N/A	Amphetamine or related acting sympathomimetic abuse, continuous
305.72	N/A	N/A	Amphetamine or related acting sympathomimetic abuse, episodic
305.80	N/A	N/A	Antidepressant type abuse, unspecified
305.81	N/A	N/A	Antidepressant type abuse, continuous
305.82	N/A	N/A	Antidepressant type abuse, episodic
305.90	N/A	N/A	Other, mixed, or unspecified drug abuse, unspecified
305.91	N/A	N/A	Other, mixed, or unspecified drug abuse, continuous
305.92	N/A	N/A	Other, mixed, or unspecified drug abuse, episodic

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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