PQRS Measure
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 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. |
| 4090F | N/A | N/A | Patient receiving erythropoietin therapy (HEM) |
| 3160F | 3P | N/A | Documentation of iron stores prior to initiating erythropoietin therapy (HEM) |
| 3160F | N/A | N/A | Documentation of iron stores prior to initiating erythropoietin therapy (HEM) |
| 3160F | 8P | N/A | Documentation of iron stores prior to initiating erythropoietin therapy (HEM) |
| 4095F | N/A | N/A | Patient not receiving erythropoietin therapy (HEM) |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 238.72 | N/A | N/A | Low grade myelodysplastic syndrome lesions |
| 238.73 | N/A | N/A | High grade myelodysplastic syndrome lesions |
| 238.74 | N/A | N/A | Myelodysplastic syndrome with 5q deletion |
| 238.75 | N/A | N/A | Myelodysplastic syndrome, unspecified |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| D46.0 | N/A | N/A | Refractory anemia without ring sideroblasts, so stated |
| D46.1 | N/A | N/A | Refractory anemia with ring sideroblasts |
| D46.20 | N/A | N/A | Refractory anemia with excess of blasts, unspecified |
| D46.21 | N/A | N/A | Refractory anemia with excess of blasts 1 |
| D46.22 | N/A | N/A | Refractory anemia with excess of blasts 2 |
| D46.4 | N/A | N/A | Refractory anemia, unspecified |
| D46.9 | N/A | N/A | Myelodysplastic syndrome, unspecified |
| D46.A | N/A | N/A | Refractory cytopenia with multilineage dysplasia |
| D46.B | N/A | N/A | Refractory cytopenia with multilineage dysplasia and ring sideroblasts |
| D46.C | N/A | N/A | Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality |
| D46.Z | N/A | N/A | Other myelodysplastic syndromes |
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/ACOThis measure can be submitted via Group Practice Reporting Option, or GPRO Web Interface.
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/ACOThis measure can be submitted via Group Practice Reporting Option, or GPRO Web Interface.
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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