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PQRS Measure

#40Osteoporosis: Management Following Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 Years and Older
 Description  Data Collection Sheet  Coding Specifications Registry OK.

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
3095FCentral dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
3096FCentral dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
4005FPharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP) (IBD)
3095F8PCentral dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
3096F8PCentral dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
4005F8PPharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP) (IBD)
3095F1PCentral dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
3095F2PCentral dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
3095F3PCentral dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
3096F1PCentral dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
3096F2PCentral dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
3096F3PCentral dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
4005F1PPharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP) (IBD)
4005F2PPharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP) (IBD)
4005F3PPharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP) (IBD)
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.
22305Closed treatment of vertebral process fracture(s)
22310Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing
22315Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction
22318Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting
22319Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting
22325Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar
22326Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical
22327Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic
22520Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; thoracic
22521Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; lumbar
22523Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); thoracic
22524Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); lumbar
25600Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation
25605Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation
25606Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation
25607Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation
25608Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments
25609Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments
27230Closed treatment of femoral fracture, proximal end, neck; without manipulation
27232Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction
27235Percutaneous skeletal fixation of femoral fracture, proximal end, neck
27236Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement
27238Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation
27240Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction
27244Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage
27245Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage
27246Closed treatment of greater trochanteric fracture, without manipulation
27248Open treatment of greater trochanteric fracture, includes internal fixation, when performed

ICD9 Codes

CodeModifierPOSDescription
733.00Osteoporosis, unspecified
733.01Senile osteoporosis
733.02Idiopathic osteoporosis
733.03Disuse osteoporosis
733.09Other osteoporosis
805.00Closed fracture of cervical vertebra, unspecified level
805.01Closed fracture of first cervical vertebra
805.02Closed fracture of second cervical vertebra
805.03Closed fracture of third cervical vertebra
805.04Closed fracture of fourth cervical vertebra
805.05Closed fracture of fifth cervical vertebra
805.06Closed fracture of sixth cervical vertebra
805.07Closed fracture of seventh cervical vertebra
805.08Closed fracture of multiple cervical vertebrae
805.2Closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury
805.4Closed fracture of lumbar vertebra without mention of spinal cord injury
805.6Closed fracture of sacrum and coccyx without mention of spinal cord injury
805.8Closed fracture of unspecified vertebral column without mention of spinal cord injury
813.40Closed fracture of lower end of forearm, unspecified
813.41Closed Colles' fracture
813.42Other closed fractures of distal end of radius (alone)
813.44Closed fracture of lower end of radius with ulna
813.45Torus fracture of radius (alone)
813.47Torus fracture of radius and ulna
813.50Open fracture of lower end of forearm, unspecified
813.51Open Colles' fracture
813.52Other open fractures of distal end of radius (alone)
813.54Open fracture of lower end of radius with ulna
820.00Closed fracture of intracapsular section of neck of femur, unspecified
820.01Closed fracture of epiphysis (separation) (upper) of neck of femur
820.02Closed fracture of midcervical section of neck of femur
820.03Closed fracture of base of neck of femur
820.09Other closed transcervical fracture of neck of femur
820.20Closed fracture of trochanteric section of neck of femur
820.21Closed fracture of intertrochanteric section of neck of femur
820.22Closed fracture of subtrochanteric section of neck of femur
820.8Closed fracture of unspecified part of neck of femur
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.
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