PQRS Information

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

PQRS Measure

#91Acute Otitis Externa (AOE): Topical Therapy

Report via: Claim, Registry

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
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.
99281	N/A	N/A	Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional
99282	N/A	N/A	Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making
99283	N/A	N/A	Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making
99284	N/A	N/A	Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making
99285	N/A	N/A	Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making
4130F	N/A	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
4130F	8P	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
4130F	1P	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
4130F	2P	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
4130F	N/A	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
4130F	8P	N/A	Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
ICD9 Codes
Code	Modifier	POS	Description
380.10	N/A	N/A	Infective otitis externa, unspecified
380.11	N/A	N/A	Acute infection of pinna
380.12	N/A	N/A	Acute swimmers' ear
380.13	N/A	N/A	Other acute infections of external ear
380.22	N/A	N/A	Other acute otitis externa
ICD10CM Codes
Code	Modifier	POS	Description
H60.00	N/A	N/A	Abscess of external ear, unspecified ear
H60.01	N/A	N/A	Abscess of right external ear
H60.02	N/A	N/A	Abscess of left external ear
H60.03	N/A	N/A	Abscess of external ear, bilateral
H60.10	N/A	N/A	Cellulitis of external ear, unspecified ear
H60.11	N/A	N/A	Cellulitis of right external ear
H60.12	N/A	N/A	Cellulitis of left external ear
H60.13	N/A	N/A	Cellulitis of external ear, bilateral
H60.311	N/A	N/A	Diffuse otitis externa, right ear
H60.312	N/A	N/A	Diffuse otitis externa, left ear
H60.313	N/A	N/A	Diffuse otitis externa, bilateral
H60.319	N/A	N/A	Diffuse otitis externa, unspecified ear
H60.321	N/A	N/A	Hemorrhagic otitis externa, right ear
H60.322	N/A	N/A	Hemorrhagic otitis externa, left ear
H60.323	N/A	N/A	Hemorrhagic otitis externa, bilateral
H60.329	N/A	N/A	Hemorrhagic otitis externa, unspecified ear
H60.331	N/A	N/A	Swimmer's ear, right ear
H60.332	N/A	N/A	Swimmer's ear, left ear
H60.333	N/A	N/A	Swimmer's ear, bilateral
H60.339	N/A	N/A	Swimmer's ear, unspecified ear
H60.391	N/A	N/A	Other infective otitis externa, right ear
H60.392	N/A	N/A	Other infective otitis externa, left ear
H60.393	N/A	N/A	Other infective otitis externa, bilateral
H60.399	N/A	N/A	Other infective otitis externa, unspecified ear
H60.501	N/A	N/A	Unspecified acute noninfective otitis externa, right ear
H60.502	N/A	N/A	Unspecified acute noninfective otitis externa, left ear
H60.503	N/A	N/A	Unspecified acute noninfective otitis externa, bilateral
H60.509	N/A	N/A	Unspecified acute noninfective otitis externa, unspecified ear
H60.511	N/A	N/A	Acute actinic otitis externa, right ear
H60.512	N/A	N/A	Acute actinic otitis externa, left ear
H60.513	N/A	N/A	Acute actinic otitis externa, bilateral
H60.519	N/A	N/A	Acute actinic otitis externa, unspecified ear
H60.521	N/A	N/A	Acute chemical otitis externa, right ear
H60.522	N/A	N/A	Acute chemical otitis externa, left ear
H60.523	N/A	N/A	Acute chemical otitis externa, bilateral
H60.529	N/A	N/A	Acute chemical otitis externa, unspecified ear
H60.531	N/A	N/A	Acute contact otitis externa, right ear
H60.532	N/A	N/A	Acute contact otitis externa, left ear
H60.533	N/A	N/A	Acute contact otitis externa, bilateral
H60.539	N/A	N/A	Acute contact otitis externa, unspecified ear
H60.541	N/A	N/A	Acute eczematoid otitis externa, right ear
H60.542	N/A	N/A	Acute eczematoid otitis externa, left ear
H60.543	N/A	N/A	Acute eczematoid otitis externa, bilateral
H60.549	N/A	N/A	Acute eczematoid otitis externa, unspecified ear
H60.551	N/A	N/A	Acute reactive otitis externa, right ear
H60.552	N/A	N/A	Acute reactive otitis externa, left ear
H60.553	N/A	N/A	Acute reactive otitis externa, bilateral
H60.559	N/A	N/A	Acute reactive otitis externa, unspecified ear
H60.591	N/A	N/A	Other noninfective acute otitis externa, right ear
H60.592	N/A	N/A	Other noninfective acute otitis externa, left ear
H60.593	N/A	N/A	Other noninfective acute otitis externa, bilateral
H60.599	N/A	N/A	Other noninfective acute otitis externa, unspecified ear
H61.90	N/A	N/A	Disorder of external ear, unspecified, unspecified ear
H61.91	N/A	N/A	Disorder of right external ear, unspecified
H61.92	N/A	N/A	Disorder of left external ear, unspecified
H61.93	N/A	N/A	Disorder of external ear, unspecified, bilateral
H62.40	N/A	N/A	Otitis externa in other diseases classified elsewhere, unspecified ear
H62.41	N/A	N/A	Otitis externa in other diseases classified elsewhere, right ear
H62.42	N/A	N/A	Otitis externa in other diseases classified elsewhere, left ear
H62.43	N/A	N/A	Otitis externa in other diseases classified elsewhere, bilateral
H62.8X1	N/A	N/A	Other disorders of right external ear in diseases classified elsewhere
H62.8X2	N/A	N/A	Other disorders of left external ear in diseases classified elsewhere
H62.8X3	N/A	N/A	Other disorders of external ear in diseases classified elsewhere, bilateral
H62.8X9	N/A	N/A	Other disorders of external ear in diseases classified elsewhere, unspecified ear

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.
SurveyThis measure can be submitted/collected via a Certified Survey Vendor.

More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.

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