PQRS Measure
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 90791 | N/A | N/A | Psychiatric diagnostic evaluation |
| 90792 | N/A | N/A | Psychiatric diagnostic evaluation with medical services |
| 90832 | N/A | N/A | Psychotherapy, 30 minutes with patient |
| 90834 | N/A | N/A | Psychotherapy, 45 minutes with patient |
| 90837 | N/A | N/A | Psychotherapy, 60 minutes with patient |
| 90839 | N/A | N/A | Psychotherapy for crisis; first 60 minutes |
| 90845 | N/A | N/A | Psychoanalysis |
| 96150 | N/A | N/A | Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment |
| 96151 | N/A | N/A | Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment |
| 96152 | N/A | N/A | Health and behavior intervention, each 15 minutes, face-to-face; individual |
| 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. |
| 4320F | 8P | N/A | Patient counseled regarding psychosocial and pharmacologic treatment options for alcohol dependence (SUD) |
| 4320F | 8P | N/A | Patient counseled regarding psychosocial and pharmacologic treatment options for alcohol dependence (SUD) |
| 4320F | N/A | N/A | Patient counseled regarding psychosocial and pharmacologic treatment options for alcohol dependence (SUD) |
| 4320F | N/A | N/A | Patient counseled regarding psychosocial and pharmacologic treatment options for alcohol dependence (SUD) |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 303.90 | N/A | N/A | Other and unspecified alcohol dependence, unspecified |
| 303.91 | N/A | N/A | Other and unspecified alcohol dependence, continuous |
| 303.92 | N/A | N/A | Other and unspecified alcohol dependence, episodic |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| F10.20 | N/A | N/A | Alcohol dependence, uncomplicated |
| F10.220 | N/A | N/A | Alcohol dependence with intoxication, uncomplicated |
| F10.221 | N/A | N/A | Alcohol dependence with intoxication delirium |
| F10.229 | N/A | N/A | Alcohol dependence with intoxication, unspecified |
| F10.230 | N/A | N/A | Alcohol dependence with withdrawal, uncomplicated |
| F10.231 | N/A | N/A | Alcohol dependence with withdrawal delirium |
| F10.232 | N/A | N/A | Alcohol dependence with withdrawal with perceptual disturbance |
| F10.239 | N/A | N/A | Alcohol dependence with withdrawal, unspecified |
| F10.24 | N/A | N/A | Alcohol dependence with alcohol-induced mood disorder |
| F10.250 | N/A | N/A | Alcohol dependence with alcohol-induced psychotic disorder with delusions |
| F10.251 | N/A | N/A | Alcohol dependence with alcohol-induced psychotic disorder with hallucinations |
| F10.259 | N/A | N/A | Alcohol dependence with alcohol-induced psychotic disorder, unspecified |
| F10.26 | N/A | N/A | Alcohol dependence with alcohol-induced persisting amnestic disorder |
| F10.27 | N/A | N/A | Alcohol dependence with alcohol-induced persisting dementia |
| F10.280 | N/A | N/A | Alcohol dependence with alcohol-induced anxiety disorder |
| F10.281 | N/A | N/A | Alcohol dependence with alcohol-induced sexual dysfunction |
| F10.282 | N/A | N/A | Alcohol dependence with alcohol-induced sleep disorder |
| F10.288 | N/A | N/A | Alcohol dependence with other alcohol-induced disorder |
| F10.29 | N/A | N/A | Alcohol dependence with unspecified alcohol-induced disorder |
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.
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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