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PQRS Measure

 Report via: Registry, Measure Group
 This measure is can be reported as part of the following groups:
 Asthma 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.
99341Home or residence 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.
99342Home or residence 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.
99343Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. 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 of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344Home or residence 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, 60 minutes must be met or exceeded.
99345Home or residence 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, 75 minutes must be met or exceeded.
99347Home or residence 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, 20 minutes must be met or exceeded.
99348Home or residence 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, 30 minutes must be met or exceeded.
99349Home or residence 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, 40 minutes must be met or exceeded.
99350Home or residence 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, 60 minutes must be met or exceeded.
1038FPersistent asthma (mild, moderate or severe) (Asthma)
4140FInhaled corticosteroids prescribed (Asthma)
4140F2PInhaled corticosteroids prescribed (Asthma)
4140F8PInhaled corticosteroids prescribed (Asthma)
4144FAlternative long-term control medication prescribed (Asthma)

ICD9 Codes

CodeModifierPOSDescription
493.00Extrinsic asthma, unspecified
493.01Extrinsic asthma with status asthmaticus
493.02Extrinsic asthma with (acute) exacerbation
493.10Intrinsic asthma, unspecified
493.11Intrinsic asthma with status asthmaticus
493.12Intrinsic asthma with (acute) exacerbation
493.20Chronic obstructive asthma, unspecified
493.21Chronic obstructive asthma with status asthmaticus
493.22Chronic obstructive asthma with (acute) exacerbation
493.81Exercise induced bronchospasm
493.82Cough variant asthma
493.90Asthma, unspecified type, unspecified
493.91Asthma, unspecified type, with status asthmaticus
493.92Asthma, unspecified type, with (acute) exacerbation

ICD10CM Codes

CodeModifierPOSDescription
J45.30Mild persistent asthma, uncomplicated
J45.31Mild persistent asthma with (acute) exacerbation
J45.32Mild persistent asthma with status asthmaticus
J45.40Moderate persistent asthma, uncomplicated
J45.41Moderate persistent asthma with (acute) exacerbation
J45.42Moderate persistent asthma with status asthmaticus
J45.50Severe persistent asthma, uncomplicated
J45.51Severe persistent asthma with (acute) exacerbation
J45.901Unspecified asthma with (acute) exacerbation
J45.902Unspecified asthma with status asthmaticus
J45.909Unspecified asthma, uncomplicated
J45.990Exercise induced bronchospasm
J45.991Cough variant asthma
J45.998Other asthma
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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