PQRS Measure
Report via: Claim, Registry, EHR, Measure Group
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 97802 | N/A | N/A | Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes |
| 97803 | N/A | N/A | Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes |
| 97804 | N/A | N/A | Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes |
| 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. |
| 99211 | N/A | N/A | Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional |
| 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. |
| 99217 | N/A | N/A | Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.]) |
| 99218 | N/A | N/A | Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low 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 problem(s) requiring admission to outpatient hospital "observation status" are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit. |
| 99219 | N/A | N/A | Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive 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 problem(s) requiring admission to outpatient hospital "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit. |
| 99221 | N/A | N/A | Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. |
| 99222 | N/A | N/A | Initial hospital inpatient or observation care, per day, for the evaluation and management of a 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, 55 minutes must be met or exceeded. |
| 99223 | N/A | N/A | Initial hospital inpatient or observation care, per day, for the evaluation and management of a 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. |
| 99231 | N/A | N/A | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded. |
| 99232 | N/A | N/A | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a 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, 35 minutes must be met or exceeded. |
| 99233 | N/A | N/A | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a 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, 50 minutes must be met or exceeded. |
| 99238 | N/A | N/A | Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter |
| 99239 | N/A | N/A | Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter |
| 99281 | N/A | N/A | Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional |
| 99282 | N/A | N/A | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making |
| 99283 | N/A | N/A | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making |
| 99284 | N/A | N/A | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making |
| 99285 | N/A | N/A | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making |
| 99291 | N/A | N/A | Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes |
| 99304 | N/A | N/A | Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded. |
| 99305 | N/A | N/A | Initial nursing facility care, per day, for the evaluation and management of a 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, 35 minutes must be met or exceeded. |
| 99306 | N/A | N/A | Initial nursing facility care, per day, for the evaluation and management of a 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, 50 minutes must be met or exceeded. |
| 99307 | N/A | N/A | Subsequent nursing facility care, per day, for the evaluation and management of a 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. |
| 99308 | N/A | N/A | Subsequent nursing facility care, per day, for the evaluation and management of a 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. |
| 99309 | N/A | N/A | Subsequent nursing facility care, per day, for the evaluation and management of a 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. |
| 99310 | N/A | N/A | Subsequent nursing facility care, per day, for the evaluation and management of a 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, 45 minutes must be met or exceeded. |
| 99315 | N/A | N/A | Nursing facility discharge management; 30 minutes or less total time on the date of the encounter |
| 99316 | N/A | N/A | Nursing facility discharge management; more than 30 minutes total time on the date of the encounter |
| 99318 | N/A | N/A | Evaluation and management of a patient involving an annual nursing facility assessment, which requires these 3 key components: A detailed interval history; A comprehensive examination; and Medical decision making that is of low to 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 patient is stable, recovering, or improving. Typically, 30 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99324 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and 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 of low severity. Typically, 20 minutes are spent with the patient and/or family or caregiver. |
| 99325 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low 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 severity. Typically, 30 minutes are spent with the patient and/or family or caregiver. |
| 99326 | N/A | N/A | Domiciliary or rest home 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 with the patient and/or family or caregiver. |
| 99327 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive 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 high severity. Typically, 60 minutes are spent with the patient and/or family or caregiver. |
| 99328 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high 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 patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent with the patient and/or family or caregiver. |
| 99334 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval 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, 15 minutes are spent with the patient and/or family or caregiver. |
| 99335 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low 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 low to moderate severity. Typically, 25 minutes are spent with the patient and/or family or caregiver. |
| 99336 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; 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, 40 minutes are spent with the patient and/or family or caregiver. |
| 99337 | N/A | N/A | Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high 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. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent with the patient and/or family or caregiver. |
| 99341 | N/A | N/A | Home 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. |
| 99342 | N/A | N/A | Home 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. |
| 99343 | N/A | N/A | Home 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. |
| 99344 | N/A | N/A | Home 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. |
| 99345 | N/A | N/A | Home 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. |
| 99347 | N/A | N/A | Home 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. |
| 99348 | N/A | N/A | Home 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. |
| 99349 | N/A | N/A | Home 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. |
| 99350 | N/A | N/A | Home 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. |
| 99455 | N/A | N/A | Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report. |
| 99456 | N/A | N/A | Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report. |
| 3060F | N/A | N/A | Positive microalbuminuria test result documented and reviewed (DM) |
| 3060F | 8P | N/A | Positive microalbuminuria test result documented and reviewed (DM) |
| 3060F | N/A | N/A | Positive microalbuminuria test result documented and reviewed (DM) |
| 3060F | 8P | N/A | Positive microalbuminuria test result documented and reviewed (DM) |
| 3061F | N/A | N/A | Negative microalbuminuria test result documented and reviewed (DM) |
| 3061F | 8P | N/A | Negative microalbuminuria test result documented and reviewed (DM) |
| 3061F | N/A | N/A | Negative microalbuminuria test result documented and reviewed (DM) |
| 3061F | 8P | N/A | Negative microalbuminuria test result documented and reviewed (DM) |
| 3062F | N/A | N/A | Positive macroalbuminuria test result documented and reviewed (DM) |
| 3062F | 8P | N/A | Positive macroalbuminuria test result documented and reviewed (DM) |
| 3062F | N/A | N/A | Positive macroalbuminuria test result documented and reviewed (DM) |
| 3062F | 8P | N/A | Positive macroalbuminuria test result documented and reviewed (DM) |
| 3066F | N/A | N/A | Documentation of treatment for nephropathy (eg, patient receiving dialysis, patient being treated for ESRD, CRF, ARF, or renal insufficiency, any visit to a nephrologist) (DM) |
| 3066F | N/A | N/A | Documentation of treatment for nephropathy (eg, patient receiving dialysis, patient being treated for ESRD, CRF, ARF, or renal insufficiency, any visit to a nephrologist) (DM) |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G0402 | N/A | N/A | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
| G0438 | N/A | N/A | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
| G0439 | N/A | N/A | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
| G8506 | N/A | N/A | Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 250.00 | N/A | N/A | Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled |
| 250.01 | N/A | N/A | Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled |
| 250.02 | N/A | N/A | Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled |
| 250.03 | N/A | N/A | Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled |
| 250.10 | N/A | N/A | Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled |
| 250.11 | N/A | N/A | Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled |
| 250.12 | N/A | N/A | Diabetes with ketoacidosis, type II or unspecified type, uncontrolled |
| 250.13 | N/A | N/A | Diabetes with ketoacidosis, type I [juvenile type], uncontrolled |
| 250.20 | N/A | N/A | Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled |
| 250.21 | N/A | N/A | Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled |
| 250.22 | N/A | N/A | Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled |
| 250.23 | N/A | N/A | Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled |
| 250.30 | N/A | N/A | Diabetes with other coma, type II or unspecified type, not stated as uncontrolled |
| 250.31 | N/A | N/A | Diabetes with other coma, type I [juvenile type], not stated as uncontrolled |
| 250.32 | N/A | N/A | Diabetes with other coma, type II or unspecified type, uncontrolled |
| 250.33 | N/A | N/A | Diabetes with other coma, type I [juvenile type], uncontrolled |
| 250.40 | N/A | N/A | Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.41 | N/A | N/A | Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.42 | N/A | N/A | Diabetes with renal manifestations, type II or unspecified type, uncontrolled |
| 250.43 | N/A | N/A | Diabetes with renal manifestations, type I [juvenile type], uncontrolled |
| 250.50 | N/A | N/A | Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.51 | N/A | N/A | Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.52 | N/A | N/A | Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled |
| 250.53 | N/A | N/A | Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled |
| 250.60 | N/A | N/A | Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.61 | N/A | N/A | Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.62 | N/A | N/A | Diabetes with neurological manifestations, type II or unspecified type, uncontrolled |
| 250.63 | N/A | N/A | Diabetes with neurological manifestations, type I [juvenile type], uncontrolled |
| 250.70 | N/A | N/A | Diabetes with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled |
| 250.71 | N/A | N/A | Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled |
| 250.72 | N/A | N/A | Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled |
| 250.73 | N/A | N/A | Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled |
| 250.80 | N/A | N/A | Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.81 | N/A | N/A | Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.82 | N/A | N/A | Diabetes with other specified manifestations, type II or unspecified type, uncontrolled |
| 250.83 | N/A | N/A | Diabetes with other specified manifestations, type I [juvenile type], uncontrolled |
| 250.90 | N/A | N/A | Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled |
| 250.91 | N/A | N/A | Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled |
| 250.92 | N/A | N/A | Diabetes with unspecified complication, type II or unspecified type, uncontrolled |
| 250.93 | N/A | N/A | Diabetes with unspecified complication, type I [juvenile type], uncontrolled |
| 357.2 | N/A | N/A | Polyneuropathy in diabetes |
| 362.01 | N/A | N/A | Background diabetic retinopathy |
| 362.02 | N/A | N/A | Proliferative diabetic retinopathy |
| 362.03 | N/A | N/A | Nonproliferative diabetic retinopathy NOS |
| 362.04 | N/A | N/A | Mild nonproliferative diabetic retinopathy |
| 362.05 | N/A | N/A | Moderate nonproliferative diabetic retinopathy |
| 362.06 | N/A | N/A | Severe nonproliferative diabetic retinopathy |
| 362.07 | N/A | N/A | Diabetic macular edema |
| 366.41 | N/A | N/A | Diabetic cataract |
| 648.00 | N/A | N/A | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable |
| 648.01 | N/A | N/A | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition |
| 648.02 | N/A | N/A | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication |
| 648.03 | N/A | N/A | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication |
| 648.04 | N/A | N/A | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| E10.10 | N/A | N/A | Type 1 diabetes mellitus with ketoacidosis without coma |
| E10.11 | N/A | N/A | Type 1 diabetes mellitus with ketoacidosis with coma |
| E10.21 | N/A | N/A | Type 1 diabetes mellitus with diabetic nephropathy |
| E10.22 | N/A | N/A | Type 1 diabetes mellitus with diabetic chronic kidney disease |
| E10.29 | N/A | N/A | Type 1 diabetes mellitus with other diabetic kidney complication |
| E10.311 | N/A | N/A | Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E10.319 | N/A | N/A | Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E10.321 | N/A | N/A | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema |
| E10.329 | N/A | N/A | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema |
| E10.331 | N/A | N/A | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema |
| E10.339 | N/A | N/A | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema |
| E10.341 | N/A | N/A | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema |
| E10.349 | N/A | N/A | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema |
| E10.351 | N/A | N/A | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| E10.359 | N/A | N/A | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema |
| E10.36 | N/A | N/A | Type 1 diabetes mellitus with diabetic cataract |
| E10.39 | N/A | N/A | Type 1 diabetes mellitus with other diabetic ophthalmic complication |
| E10.40 | N/A | N/A | Type 1 diabetes mellitus with diabetic neuropathy, unspecified |
| E10.41 | N/A | N/A | Type 1 diabetes mellitus with diabetic mononeuropathy |
| E10.42 | N/A | N/A | Type 1 diabetes mellitus with diabetic polyneuropathy |
| E10.43 | N/A | N/A | Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E10.44 | N/A | N/A | Type 1 diabetes mellitus with diabetic amyotrophy |
| E10.49 | N/A | N/A | Type 1 diabetes mellitus with other diabetic neurological complication |
| E10.51 | N/A | N/A | Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene |
| E10.52 | N/A | N/A | Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E10.59 | N/A | N/A | Type 1 diabetes mellitus with other circulatory complications |
| E10.610 | N/A | N/A | Type 1 diabetes mellitus with diabetic neuropathic arthropathy |
| E10.618 | N/A | N/A | Type 1 diabetes mellitus with other diabetic arthropathy |
| E10.620 | N/A | N/A | Type 1 diabetes mellitus with diabetic dermatitis |
| E10.621 | N/A | N/A | Type 1 diabetes mellitus with foot ulcer |
| E10.622 | N/A | N/A | Type 1 diabetes mellitus with other skin ulcer |
| E10.628 | N/A | N/A | Type 1 diabetes mellitus with other skin complications |
| E10.630 | N/A | N/A | Type 1 diabetes mellitus with periodontal disease |
| E10.638 | N/A | N/A | Type 1 diabetes mellitus with other oral complications |
| E10.641 | N/A | N/A | Type 1 diabetes mellitus with hypoglycemia with coma |
| E10.649 | N/A | N/A | Type 1 diabetes mellitus with hypoglycemia without coma |
| E10.65 | N/A | N/A | Type 1 diabetes mellitus with hyperglycemia |
| E10.69 | N/A | N/A | Type 1 diabetes mellitus with other specified complication |
| E10.8 | N/A | N/A | Type 1 diabetes mellitus with unspecified complications |
| E10.9 | N/A | N/A | Type 1 diabetes mellitus without complications |
| E11.00 | N/A | N/A | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E11.01 | N/A | N/A | Type 2 diabetes mellitus with hyperosmolarity with coma |
| E11.21 | N/A | N/A | Type 2 diabetes mellitus with diabetic nephropathy |
| E11.22 | N/A | N/A | Type 2 diabetes mellitus with diabetic chronic kidney disease |
| E11.29 | N/A | N/A | Type 2 diabetes mellitus with other diabetic kidney complication |
| E11.311 | N/A | N/A | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E11.319 | N/A | N/A | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E11.321 | N/A | N/A | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema |
| E11.329 | N/A | N/A | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema |
| E11.331 | N/A | N/A | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema |
| E11.339 | N/A | N/A | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema |
| E11.341 | N/A | N/A | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema |
| E11.349 | N/A | N/A | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema |
| E11.351 | N/A | N/A | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| E11.359 | N/A | N/A | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema |
| E11.36 | N/A | N/A | Type 2 diabetes mellitus with diabetic cataract |
| E11.39 | N/A | N/A | Type 2 diabetes mellitus with other diabetic ophthalmic complication |
| E11.40 | N/A | N/A | Type 2 diabetes mellitus with diabetic neuropathy, unspecified |
| E11.41 | N/A | N/A | Type 2 diabetes mellitus with diabetic mononeuropathy |
| E11.42 | N/A | N/A | Type 2 diabetes mellitus with diabetic polyneuropathy |
| E11.43 | N/A | N/A | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E11.44 | N/A | N/A | Type 2 diabetes mellitus with diabetic amyotrophy |
| E11.49 | N/A | N/A | Type 2 diabetes mellitus with other diabetic neurological complication |
| E11.51 | N/A | N/A | Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene |
| E11.52 | N/A | N/A | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E11.59 | N/A | N/A | Type 2 diabetes mellitus with other circulatory complications |
| E11.610 | N/A | N/A | Type 2 diabetes mellitus with diabetic neuropathic arthropathy |
| E11.618 | N/A | N/A | Type 2 diabetes mellitus with other diabetic arthropathy |
| E11.620 | N/A | N/A | Type 2 diabetes mellitus with diabetic dermatitis |
| E11.621 | N/A | N/A | Type 2 diabetes mellitus with foot ulcer |
| E11.622 | N/A | N/A | Type 2 diabetes mellitus with other skin ulcer |
| E11.628 | N/A | N/A | Type 2 diabetes mellitus with other skin complications |
| E11.630 | N/A | N/A | Type 2 diabetes mellitus with periodontal disease |
| E11.638 | N/A | N/A | Type 2 diabetes mellitus with other oral complications |
| E11.641 | N/A | N/A | Type 2 diabetes mellitus with hypoglycemia with coma |
| E11.649 | N/A | N/A | Type 2 diabetes mellitus with hypoglycemia without coma |
| E11.65 | N/A | N/A | Type 2 diabetes mellitus with hyperglycemia |
| E11.69 | N/A | N/A | Type 2 diabetes mellitus with other specified complication |
| E11.8 | N/A | N/A | Type 2 diabetes mellitus with unspecified complications |
| E11.9 | N/A | N/A | Type 2 diabetes mellitus without complications |
| O24.011 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in pregnancy, first trimester |
| O24.012 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in pregnancy, second trimester |
| O24.013 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in pregnancy, third trimester |
| O24.019 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in pregnancy, unspecified trimester |
| O24.02 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in childbirth |
| O24.03 | N/A | N/A | Pre-existing type 1 diabetes mellitus, in the puerperium |
| O24.111 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester |
| O24.112 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in pregnancy, second trimester |
| O24.113 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester |
| O24.119 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester |
| O24.12 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in childbirth |
| O24.13 | N/A | N/A | Pre-existing type 2 diabetes mellitus, in the puerperium |
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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