PQRS Measure
#106Adult Major Depressive Disorder (MDD): Comprehensive Depression Evaluation: Diagnosis and Severity
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 |
| 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. |
| 1040F | N/A | N/A | DSM-5 criteria for major depressive disorder documented at the initial evaluation (MDD, MDD ADOL) |
| 1040F | 8P | N/A | DSM-5 criteria for major depressive disorder documented at the initial evaluation (MDD, MDD ADOL) |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8930 | N/A | N/A | Assessment of depression severity at the initial evaluation |
| G8931 | N/A | N/A | Assessment of depression severity not documented, reason not given |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 296.20 | N/A | N/A | Major depressive affective disorder, single episode, unspecified |
| 296.21 | N/A | N/A | Major depressive affective disorder, single episode, mild |
| 296.22 | N/A | N/A | Major depressive affective disorder, single episode, moderate |
| 296.23 | N/A | N/A | Major depressive affective disorder, single episode, severe, without mention of psychotic behavior |
| 296.24 | N/A | N/A | Major depressive affective disorder, single episode, severe, specified as with psychotic behavior |
| 296.30 | N/A | N/A | Major depressive affective disorder, recurrent episode, unspecified |
| 296.31 | N/A | N/A | Major depressive affective disorder, recurrent episode, mild |
| 296.32 | N/A | N/A | Major depressive affective disorder, recurrent episode, moderate |
| 296.33 | N/A | N/A | Major depressive affective disorder, recurrent episode, severe, without mention of psychotic behavior |
| 296.34 | N/A | N/A | Major depressive affective disorder, recurrent episode, severe, specified as with psychotic behavior |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| F32.0 | N/A | N/A | Major depressive disorder, single episode, mild |
| F32.1 | N/A | N/A | Major depressive disorder, single episode, moderate |
| F32.2 | N/A | N/A | Major depressive disorder, single episode, severe without psychotic features |
| F32.3 | N/A | N/A | Major depressive disorder, single episode, severe with psychotic features |
| F32.9 | N/A | N/A | Major depressive disorder, single episode, unspecified |
| F33.0 | N/A | N/A | Major depressive disorder, recurrent, mild |
| F33.1 | N/A | N/A | Major depressive disorder, recurrent, moderate |
| F33.2 | N/A | N/A | Major depressive disorder, recurrent severe without psychotic features |
| F33.3 | N/A | N/A | Major depressive disorder, recurrent, severe with psychotic symptoms |
| F33.9 | N/A | N/A | Major depressive disorder, recurrent, 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).
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.
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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