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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.
3155FN/AN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155F8PN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155F1PN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155F2PN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155F3PN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155FN/AN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)
3155F8PN/ACytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment (HEM)

ICD9 Codes

CodeModifierPOSDescription
204.00N/AN/AAcute lymphoid leukemia, without mention of having achieved remission
204.02N/AN/AAcute lymphoid leukemia, in relapse
205.00N/AN/AAcute myeloid leukemia, without mention of having achieved remission
205.02N/AN/AAcute myeloid leukemia, in relapse
206.00N/AN/AAcute monocytic leukemia, without mention of having achieved remission
206.02N/AN/AAcute monocytic leukemia, in relapse
207.00N/AN/AAcute erythremia and erythroleukemia, without mention of having achieved remission
207.02N/AN/AAcute erythremia and erythroleukemia, in relapse
207.20N/AN/AMegakaryocytic leukemia, without mention of having achieved remission
207.22N/AN/AMegakaryocytic leukemia, in relapse
208.00N/AN/AAcute leukemia of unspecified cell type, without mention of having achieved remission
208.02N/AN/AAcute leukemia of unspecified cell type, in relapse
238.72N/AN/ALow grade myelodysplastic syndrome lesions
238.73N/AN/AHigh grade myelodysplastic syndrome lesions
238.74N/AN/AMyelodysplastic syndrome with 5q deletion
238.75N/AN/AMyelodysplastic syndrome, unspecified

ICD10CM Codes

CodeModifierPOSDescription
C91.00N/AN/AAcute lymphoblastic leukemia not having achieved remission
C91.02N/AN/AAcute lymphoblastic leukemia, in relapse
C92.00N/AN/AAcute myeloblastic leukemia, not having achieved remission
C92.02N/AN/AAcute myeloblastic leukemia, in relapse
C92.40N/AN/AAcute promyelocytic leukemia, not having achieved remission
C92.42N/AN/AAcute promyelocytic leukemia, in relapse
C92.50N/AN/AAcute myelomonocytic leukemia, not having achieved remission
C92.52N/AN/AAcute myelomonocytic leukemia, in relapse
C92.60N/AN/AAcute myeloid leukemia with 11q23-abnormality not having achieved remission
C92.62N/AN/AAcute myeloid leukemia with 11q23-abnormality in relapse
C92.A0N/AN/AAcute myeloid leukemia with multilineage dysplasia, not having achieved remission
C92.A2N/AN/AAcute myeloid leukemia with multilineage dysplasia, in relapse
C93.00N/AN/AAcute monoblastic/monocytic leukemia, not having achieved remission
C93.02N/AN/AAcute monoblastic/monocytic leukemia, in relapse
C94.00N/AN/AAcute erythroid leukemia, not having achieved remission
C94.02N/AN/AAcute erythroid leukemia, in relapse
C94.20N/AN/AAcute megakaryoblastic leukemia not having achieved remission
C94.22N/AN/AAcute megakaryoblastic leukemia, in relapse
C95.00N/AN/AAcute leukemia of unspecified cell type not having achieved remission
C95.02N/AN/AAcute leukemia of unspecified cell type, in relapse
D46.0N/AN/ARefractory anemia without ring sideroblasts, so stated
D46.1N/AN/ARefractory anemia with ring sideroblasts
D46.20N/AN/ARefractory anemia with excess of blasts, unspecified
D46.21N/AN/ARefractory anemia with excess of blasts 1
D46.22N/AN/ARefractory anemia with excess of blasts 2
D46.4N/AN/ARefractory anemia, unspecified
D46.9N/AN/AMyelodysplastic syndrome, unspecified
D46.AN/AN/ARefractory cytopenia with multilineage dysplasia
D46.BN/AN/ARefractory cytopenia with multilineage dysplasia and ring sideroblasts
D46.CN/AN/AMyelodysplastic syndrome with isolated del(5q) chromosomal abnormality
D46.ZN/AN/AOther 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.
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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