PQRS Measure
#161HIV/AIDS: Adolescent and Adult Patients with HIV/AIDS Who Are Prescribed Potent Antiretroviral Therapy
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 4276F | Potent antiretroviral therapy prescribed (HIV) | ||
| 3492F | History of nadir CD4+ cell count <350 cells/mm3 (HIV) | ||
| 3490F | History of AIDS-defining condition (HIV) | ||
| 3493F | No history of nadir CD4+ cell count <350 cells/mm3 and no history of AIDS-defining condition (HIV) | ||
| 4276F | 8P | Potent antiretroviral therapy prescribed (HIV) | |
| 99201 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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. | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 042 | Human immunodeficiency virus [HIV] disease | ||
| 079.53 | Human immunodeficiency virus, type 2 [HIV-2] | ||
| V08 | Asymptomatic human immunodeficiency virus [HIV] infection status | ||
| V22.0 | Supervision of normal first pregnancy | ||
| V22.1 | Supervision of other normal pregnancy | ||
| V22.2 | Pregnant state, incidental | ||
| V23.0 | Supervision of high-risk pregnancy with history of infertility | ||
| V23.1 | Supervision of high-risk pregnancy with history of trophoblastic disease | ||
| V23.2 | Supervision of high-risk pregnancy with history of abortion | ||
| V23.3 | Supervision of high-risk pregnancy with grand multiparity | ||
| V23.41 | Pregnancy with history of pre-term labor | ||
| V23.49 | Pregnancy with other poor obstetric history | ||
| V23.5 | Supervision of high-risk pregnancy with other poor reproductive history | ||
| V23.7 | Supervision of high-risk pregnancy with insufficient prenatal care | ||
| V23.81 | Supervision of high-risk pregnancy with elderly primigravida | ||
| V23.82 | Supervision of high-risk pregnancy with elderly multigravida | ||
| V23.83 | Supervision of high-risk pregnancy with young primigravida | ||
| V23.84 | Supervision of high-risk pregnancy with young multigravida | ||
| V23.89 | Supervision of other high-risk pregnancy | ||
| V23.9 | Supervision of unspecified high-risk pregnancy | ||
Legend:
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
Registry OKThis measure can be submitted through registry.
EHR OKThis measure can be submitted via Electronic Health Record (EHR).
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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