PQRS Measure
This measure may be submitted via Registry only
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 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. |
| 99291 | N/A | N/A | Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8600 | N/A | N/A | Iv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well |
| G8601 | N/A | N/A | Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention) |
| G8602 | N/A | N/A | Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well, reason not given |
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 433.01 | N/A | N/A | Occlusion and stenosis of basilar artery with cerebral infarction |
| 433.10 | N/A | N/A | Occlusion and stenosis of carotid artery without mention of cerebral infarction |
| 433.11 | N/A | N/A | Occlusion and stenosis of carotid artery with cerebral infarction |
| 433.21 | N/A | N/A | Occlusion and stenosis of vertebral artery with cerebral infarction |
| 433.31 | N/A | N/A | Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction |
| 433.81 | N/A | N/A | Occlusion and stenosis of other specified precerebral artery with cerebral infarction |
| 433.91 | N/A | N/A | Occlusion and stenosis of unspecified precerebral artery with cerebral infarction |
| 434.00 | N/A | N/A | Cerebral thrombosis without mention of cerebral infarction |
| 434.01 | N/A | N/A | Cerebral thrombosis with cerebral infarction |
| 434.11 | N/A | N/A | Cerebral embolism with cerebral infarction |
| 434.91 | N/A | N/A | Cerebral artery occlusion, unspecified with cerebral infarction |
| 436 | N/A | N/A | Acute, but ill-defined, cerebrovascular disease |
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| I63.111 | N/A | N/A | Cerebral infarction due to embolism of right vertebral artery |
| I63.112 | N/A | N/A | Cerebral infarction due to embolism of left vertebral artery |
| I63.119 | N/A | N/A | Cerebral infarction due to embolism of unspecified vertebral artery |
| I63.139 | N/A | N/A | Cerebral infarction due to embolism of unspecified carotid artery |
| I63.19 | N/A | N/A | Cerebral infarction due to embolism of other precerebral artery |
| I63.20 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries |
| I63.219 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery |
| I63.22 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of basilar artery |
| I63.231 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries |
| I63.232 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries |
| I63.239 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery |
| I63.30 | N/A | N/A | Cerebral infarction due to thrombosis of unspecified cerebral artery |
| I63.40 | N/A | N/A | Cerebral infarction due to embolism of unspecified cerebral artery |
| I63.50 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery |
| I63.59 | N/A | N/A | Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery |
| I65.29 | N/A | N/A | Occlusion and stenosis of unspecified carotid artery |
| I66.02 | N/A | N/A | Occlusion and stenosis of left middle cerebral artery |
| I66.03 | N/A | N/A | Occlusion and stenosis of bilateral middle cerebral arteries |
| I66.09 | N/A | N/A | Occlusion and stenosis of unspecified middle cerebral artery |
| I66.19 | N/A | N/A | Occlusion and stenosis of unspecified anterior cerebral artery |
| I66.29 | N/A | N/A | Occlusion and stenosis of unspecified posterior cerebral artery |
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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