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PQRS Measure

 Report via: Claim, Registry

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
99201N/AN/AOffice 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.
99202N/AN/AOffice 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.
99203N/AN/AOffice 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.
99204N/AN/AOffice 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.
99205N/AN/AOffice 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.
99212N/AN/AOffice 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.
99213N/AN/AOffice 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.
99214N/AN/AOffice 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.
99215N/AN/AOffice 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.
1007FN/AN/AUse of anti-inflammatory or analgesic over-the-counter (OTC) medications for symptom relief assessed (OA)
1007F8PN/AUse of anti-inflammatory or analgesic over-the-counter (OTC) medications for symptom relief assessed (OA)

ICD9 Codes

CodeModifierPOSDescription
715.00N/AN/AOsteoarthrosis, generalized, site unspecified
715.04N/AN/AOsteoarthrosis, generalized, hand
715.09N/AN/AOsteoarthrosis, generalized, multiple sites
715.10N/AN/AOsteoarthrosis, localized, primary, site unspecified
715.11N/AN/AOsteoarthrosis, localized, primary, shoulder region
715.12N/AN/AOsteoarthrosis, localized, primary, upper arm
715.13N/AN/AOsteoarthrosis, localized, primary, forearm
715.14N/AN/AOsteoarthrosis, localized, primary, hand
715.15N/AN/AOsteoarthrosis, localized, primary, pelvic region and thigh
715.16N/AN/AOsteoarthrosis, localized, primary, lower leg
715.17N/AN/AOsteoarthrosis, localized, primary, ankle and foot
715.18N/AN/AOsteoarthrosis, localized, primary, other specified sites
715.20N/AN/AOsteoarthrosis, localized, secondary, site unspecified
715.21N/AN/AOsteoarthrosis, localized, secondary, shoulder region
715.22N/AN/AOsteoarthrosis, localized, secondary, upper arm
715.23N/AN/AOsteoarthrosis, localized, secondary, forearm
715.24N/AN/AOsteoarthrosis, localized, secondary, hand
715.25N/AN/AOsteoarthrosis, localized, secondary, pelvic region and thigh
715.26N/AN/AOsteoarthrosis, localized, secondary, lower leg
715.27N/AN/AOsteoarthrosis, localized, secondary, ankle and foot
715.28N/AN/AOsteoarthrosis, localized, secondary, other specified sites
715.30N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, site unspecified
715.31N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, shoulder region
715.32N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, upper arm
715.33N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, forearm
715.34N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, hand
715.35N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh
715.36N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, lower leg
715.37N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, ankle and foot
715.38N/AN/AOsteoarthrosis, localized, not specified whether primary or secondary, other specified sites
715.80N/AN/AOsteoarthrosis involving, or with mention of more than one site, but not specified as generalized, site unspecified
715.89N/AN/AOsteoarthrosis involving, or with mention of more than one site, but not specified as generalized, multiple sites
715.90N/AN/AOsteoarthrosis, unspecified whether generalized or localized, site unspecified
715.91N/AN/AOsteoarthrosis, unspecified whether generalized or localized, shoulder region
715.92N/AN/AOsteoarthrosis, unspecified whether generalized or localized, upper arm
715.93N/AN/AOsteoarthrosis, unspecified whether generalized or localized, forearm
715.94N/AN/AOsteoarthrosis, unspecified whether generalized or localized, hand
715.95N/AN/AOsteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh
715.96N/AN/AOsteoarthrosis, unspecified whether generalized or localized, lower leg
715.97N/AN/AOsteoarthrosis, unspecified whether generalized or localized, ankle and foot
715.98N/AN/AOsteoarthrosis, unspecified whether generalized or localized, other specified sites

ICD10CM Codes

CodeModifierPOSDescription
M15.0N/AN/APrimary generalized (osteo)arthritis
M15.1N/AN/AHeberden's nodes (with arthropathy)
M15.2N/AN/ABouchard's nodes (with arthropathy)
M15.3N/AN/ASecondary multiple arthritis
M15.4N/AN/AErosive (osteo)arthritis
M15.8N/AN/AOther polyosteoarthritis
M15.9N/AN/APolyosteoarthritis, unspecified
M16.0N/AN/ABilateral primary osteoarthritis of hip
M16.10N/AN/AUnilateral primary osteoarthritis, unspecified hip
M16.11N/AN/AUnilateral primary osteoarthritis, right hip
M16.12N/AN/AUnilateral primary osteoarthritis, left hip
M16.2N/AN/ABilateral osteoarthritis resulting from hip dysplasia
M16.30N/AN/AUnilateral osteoarthritis resulting from hip dysplasia, unspecified hip
M16.31N/AN/AUnilateral osteoarthritis resulting from hip dysplasia, right hip
M16.32N/AN/AUnilateral osteoarthritis resulting from hip dysplasia, left hip
M16.4N/AN/ABilateral post-traumatic osteoarthritis of hip
M16.50N/AN/AUnilateral post-traumatic osteoarthritis, unspecified hip
M16.51N/AN/AUnilateral post-traumatic osteoarthritis, right hip
M16.52N/AN/AUnilateral post-traumatic osteoarthritis, left hip
M16.6N/AN/AOther bilateral secondary osteoarthritis of hip
M16.7N/AN/AOther unilateral secondary osteoarthritis of hip
M16.9N/AN/AOsteoarthritis of hip, unspecified
M17.0N/AN/ABilateral primary osteoarthritis of knee
M17.10N/AN/AUnilateral primary osteoarthritis, unspecified knee
M17.11N/AN/AUnilateral primary osteoarthritis, right knee
M17.12N/AN/AUnilateral primary osteoarthritis, left knee
M17.2N/AN/ABilateral post-traumatic osteoarthritis of knee
M17.30N/AN/AUnilateral post-traumatic osteoarthritis, unspecified knee
M17.31N/AN/AUnilateral post-traumatic osteoarthritis, right knee
M17.32N/AN/AUnilateral post-traumatic osteoarthritis, left knee
M17.4N/AN/AOther bilateral secondary osteoarthritis of knee
M17.5N/AN/AOther unilateral secondary osteoarthritis of knee
M17.9N/AN/AOsteoarthritis of knee, unspecified
M18.0N/AN/ABilateral primary osteoarthritis of first carpometacarpal joints
M18.10N/AN/AUnilateral primary osteoarthritis of first carpometacarpal joint, unspecified hand
M18.11N/AN/AUnilateral primary osteoarthritis of first carpometacarpal joint, right hand
M18.12N/AN/AUnilateral primary osteoarthritis of first carpometacarpal joint, left hand
M18.2N/AN/ABilateral post-traumatic osteoarthritis of first carpometacarpal joints
M18.30N/AN/AUnilateral post-traumatic osteoarthritis of first carpometacarpal joint, unspecified hand
M18.31N/AN/AUnilateral post-traumatic osteoarthritis of first carpometacarpal joint, right hand
M18.32N/AN/AUnilateral post-traumatic osteoarthritis of first carpometacarpal joint, left hand
M18.4N/AN/AOther bilateral secondary osteoarthritis of first carpometacarpal joints
M18.50N/AN/AOther unilateral secondary osteoarthritis of first carpometacarpal joint, unspecified hand
M18.51N/AN/AOther unilateral secondary osteoarthritis of first carpometacarpal joint, right hand
M18.52N/AN/AOther unilateral secondary osteoarthritis of first carpometacarpal joint, left hand
M18.9N/AN/AOsteoarthritis of first carpometacarpal joint, unspecified
M19.011N/AN/APrimary osteoarthritis, right shoulder
M19.012N/AN/APrimary osteoarthritis, left shoulder
M19.019N/AN/APrimary osteoarthritis, unspecified shoulder
M19.021N/AN/APrimary osteoarthritis, right elbow
M19.022N/AN/APrimary osteoarthritis, left elbow
M19.029N/AN/APrimary osteoarthritis, unspecified elbow
M19.031N/AN/APrimary osteoarthritis, right wrist
M19.032N/AN/APrimary osteoarthritis, left wrist
M19.039N/AN/APrimary osteoarthritis, unspecified wrist
M19.041N/AN/APrimary osteoarthritis, right hand
M19.042N/AN/APrimary osteoarthritis, left hand
M19.049N/AN/APrimary osteoarthritis, unspecified hand
M19.071N/AN/APrimary osteoarthritis, right ankle and foot
M19.072N/AN/APrimary osteoarthritis, left ankle and foot
M19.079N/AN/APrimary osteoarthritis, unspecified ankle and foot
M19.111N/AN/APost-traumatic osteoarthritis, right shoulder
M19.112N/AN/APost-traumatic osteoarthritis, left shoulder
M19.119N/AN/APost-traumatic osteoarthritis, unspecified shoulder
M19.121N/AN/APost-traumatic osteoarthritis, right elbow
M19.122N/AN/APost-traumatic osteoarthritis, left elbow
M19.129N/AN/APost-traumatic osteoarthritis, unspecified elbow
M19.131N/AN/APost-traumatic osteoarthritis, right wrist
M19.132N/AN/APost-traumatic osteoarthritis, left wrist
M19.139N/AN/APost-traumatic osteoarthritis, unspecified wrist
M19.141N/AN/APost-traumatic osteoarthritis, right hand
M19.142N/AN/APost-traumatic osteoarthritis, left hand
M19.149N/AN/APost-traumatic osteoarthritis, unspecified hand
M19.171N/AN/APost-traumatic osteoarthritis, right ankle and foot
M19.172N/AN/APost-traumatic osteoarthritis, left ankle and foot
M19.179N/AN/APost-traumatic osteoarthritis, unspecified ankle and foot
M19.211N/AN/ASecondary osteoarthritis, right shoulder
M19.212N/AN/ASecondary osteoarthritis, left shoulder
M19.219N/AN/ASecondary osteoarthritis, unspecified shoulder
M19.221N/AN/ASecondary osteoarthritis, right elbow
M19.222N/AN/ASecondary osteoarthritis, left elbow
M19.229N/AN/ASecondary osteoarthritis, unspecified elbow
M19.231N/AN/ASecondary osteoarthritis, right wrist
M19.232N/AN/ASecondary osteoarthritis, left wrist
M19.239N/AN/ASecondary osteoarthritis, unspecified wrist
M19.241N/AN/ASecondary osteoarthritis, right hand
M19.242N/AN/ASecondary osteoarthritis, left hand
M19.249N/AN/ASecondary osteoarthritis, unspecified hand
M19.271N/AN/ASecondary osteoarthritis, right ankle and foot
M19.272N/AN/ASecondary osteoarthritis, left ankle and foot
M19.279N/AN/ASecondary osteoarthritis, unspecified ankle and foot
M19.90N/AN/AUnspecified osteoarthritis, unspecified site
M19.91N/AN/APrimary osteoarthritis, unspecified site
M19.92N/AN/APost-traumatic osteoarthritis, unspecified site
M19.93N/AN/ASecondary osteoarthritis, unspecified site
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.
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