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PQRS Measure

#83Hepatitis C: Testing for Chronic Hepatitis C - Confirmation of Hepatitis C Viremia
 This measure may be submitted via registry only.

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
1119FInitial evaluation for condition (HEP C) (EPI, DSP)
3265F1PRibonucleic acid (RNA) testing for Hepatitis C viremia ordered or results documented (HEP C)
3265F2PRibonucleic acid (RNA) testing for Hepatitis C viremia ordered or results documented (HEP C)
3265FRibonucleic acid (RNA) testing for Hepatitis C viremia ordered or results documented (HEP C)
3265F8PRibonucleic acid (RNA) testing for Hepatitis C viremia ordered or results documented (HEP C)
1121FSubsequent evaluation for condition (HEP C) (EPI)
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.

ICD9 Codes

CodeModifierPOSDescription
070.51Acute hepatitis C without mention of hepatic coma
070.54Chronic hepatitis C without mention of hepatic coma
070.70Unspecified viral hepatitis C without hepatic coma
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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