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PQRS Measure

 Report via: Claim, Registry, Measure Group
 This measure is can be reported as part of the following groups:
 Chronic Obstructive Pulmonary Disease (COPD) Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
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.
4025F1PInhaled bronchodilator prescribed (COPD)
4025F2PInhaled bronchodilator prescribed (COPD)
4025F3PInhaled bronchodilator prescribed (COPD)
4025FInhaled bronchodilator prescribed (COPD)
4025FInhaled bronchodilator prescribed (COPD)
4025F8PInhaled bronchodilator prescribed (COPD)
4025F8PInhaled bronchodilator prescribed (COPD)

HCPCS Codes

CodeModifierPOSDescription
G8924Spirometry results documented (fev1/fvc < 70%)
G8924Spirometry results documented (fev1/fvc < 70%)
G8924Spirometry results documented (fev1/fvc < 70%)
G8924Spirometry results documented (fev1/fvc < 70%)
G8925Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms
G8926Spirometry test not performed or documented, reason not given

ICD9 Codes

CodeModifierPOSDescription
491.0Simple chronic bronchitis
491.1Mucopurulent chronic bronchitis
491.20Obstructive chronic bronchitis without exacerbation
491.21Obstructive chronic bronchitis with (acute) exacerbation
491.22Obstructive chronic bronchitis with acute bronchitis
491.8Other chronic bronchitis
491.9Unspecified chronic bronchitis
492.0Emphysematous bleb
492.8Other emphysema
493.20Chronic obstructive asthma, unspecified
493.21Chronic obstructive asthma with status asthmaticus
493.22Chronic obstructive asthma with (acute) exacerbation
496Chronic airway obstruction, not elsewhere classified

ICD10CM Codes

CodeModifierPOSDescription
J41.0Simple chronic bronchitis
J41.1Mucopurulent chronic bronchitis
J41.8Mixed simple and mucopurulent chronic bronchitis
J42Unspecified chronic bronchitis
J43.0Unilateral pulmonary emphysema [MacLeod's syndrome]
J43.1Panlobular emphysema
J43.2Centrilobular emphysema
J43.8Other emphysema
J43.9Emphysema, unspecified
J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.1Chronic obstructive pulmonary disease with (acute) exacerbation
J44.9Chronic obstructive pulmonary disease, unspecified
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).
GPROThis 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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