PQRS Measure
#204Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
Description Data Collection Sheet Coding Specifications Registry OK.
This measure is can be reported as part of the following groups:
Ischemic Vascular Disease (IVD) Group
Ischemic Vascular Disease (IVD) Group
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 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. | ||
| 99211 | 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 | 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. | ||
| 99217 | 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 | 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 | 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. | ||
| 99220 | 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 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 problem(s) requiring admission to outpatient hospital "observation status" are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit. | ||
| 99341 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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. | ||
| 33510 | Coronary artery bypass, vein only; single coronary venous graft | ||
| 33511 | Coronary artery bypass, vein only; 2 coronary venous grafts | ||
| 33512 | Coronary artery bypass, vein only; 3 coronary venous grafts | ||
| 33513 | Coronary artery bypass, vein only; 4 coronary venous grafts | ||
| 33514 | Coronary artery bypass, vein only; 5 coronary venous grafts | ||
| 33516 | Coronary artery bypass, vein only; 6 or more coronary venous grafts | ||
| 33517 | Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure) | ||
| 33518 | Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure) | ||
| 33519 | Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (List separately in addition to code for primary procedure) | ||
| 33521 | Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure) | ||
| 33522 | Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure) | ||
| 33523 | Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure) | ||
| 33533 | Coronary artery bypass, using arterial graft(s); single arterial graft | ||
| 33534 | Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts | ||
| 33535 | Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts | ||
| 33536 | Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts | ||
| 33140 | Transmyocardial laser revascularization, by thoracotomy; (separate procedure) | ||
| 92980 | Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel | ||
| 92982 | Percutaneous transluminal coronary balloon angioplasty; single vessel | ||
| 92995 | Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; single vessel | ||
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8598 | Aspirin or another antiplatelet therapy used | ||
| G8599 | Aspirin or another antiplatelet therapy not used, reason not given | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 410.11 | Acute myocardial infarction of other anterior wall, initial episode of care | ||
| 410.21 | Acute myocardial infarction of inferolateral wall, initial episode of care | ||
| 410.31 | Acute myocardial infarction of inferoposterior wall, initial episode of care | ||
| 410.41 | Acute myocardial infarction of other inferior wall, initial episode of care | ||
| 410.51 | Acute myocardial infarction of other lateral wall, initial episode of care | ||
| 410.61 | True posterior wall infarction, initial episode of care | ||
| 410.71 | Subendocardial infarction, initial episode of care | ||
| 410.81 | Acute myocardial infarction of other specified sites, initial episode of care | ||
| 410.91 | Acute myocardial infarction of unspecified site, initial episode of care | ||
| 411.0 | Postmyocardial infarction syndrome | ||
| 411.1 | Intermediate coronary syndrome | ||
| 411.81 | Acute coronary occlusion without myocardial infarction | ||
| 411.89 | Other acute and subacute forms of ischemic heart disease, other | ||
| 413.0 | Angina decubitus | ||
| 413.1 | Prinzmetal angina | ||
| 413.9 | Other and unspecified angina pectoris | ||
| 414.00 | Coronary atherosclerosis of unspecified type of vessel, native or graft | ||
| 414.01 | Coronary atherosclerosis of native coronary artery | ||
| 414.02 | Coronary atherosclerosis of autologous vein bypass graft | ||
| 414.03 | Coronary atherosclerosis of nonautologous biological bypass graft | ||
| 414.04 | Coronary atherosclerosis of artery bypass graft | ||
| 414.05 | Coronary atherosclerosis of unspecified bypass graft | ||
| 414.06 | Coronary atherosclerosis of native coronary artery of transplanted heart | ||
| 414.07 | Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart | ||
| 414.8 | Other specified forms of chronic ischemic heart disease | ||
| 414.9 | Chronic ischemic heart disease, unspecified | ||
| 429.2 | Cardiovascular disease, unspecified | ||
| 433.00 | Occlusion and stenosis of basilar artery without mention of cerebral infarction | ||
| 433.01 | Occlusion and stenosis of basilar artery with cerebral infarction | ||
| 433.10 | Occlusion and stenosis of carotid artery without mention of cerebral infarction | ||
| 433.11 | Occlusion and stenosis of carotid artery with cerebral infarction | ||
| 433.20 | Occlusion and stenosis of vertebral artery without mention of cerebral infarction | ||
| 433.21 | Occlusion and stenosis of vertebral artery with cerebral infarction | ||
| 433.30 | Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction | ||
| 433.31 | Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction | ||
| 433.80 | Occlusion and stenosis of other specified precerebral artery without mention of cerebral infarction | ||
| 433.81 | Occlusion and stenosis of other specified precerebral artery with cerebral infarction | ||
| 433.90 | Occlusion and stenosis of unspecified precerebral artery without mention of cerebral infarction | ||
| 433.91 | Occlusion and stenosis of unspecified precerebral artery with cerebral infarction | ||
| 434.00 | Cerebral thrombosis without mention of cerebral infarction | ||
| 434.01 | Cerebral thrombosis with cerebral infarction | ||
| 434.10 | Cerebral embolism without mention of cerebral infarction | ||
| 434.11 | Cerebral embolism with cerebral infarction | ||
| 434.90 | Cerebral artery occlusion, unspecified without mention of cerebral infarction | ||
| 434.91 | Cerebral artery occlusion, unspecified with cerebral infarction | ||
| 440.1 | Atherosclerosis of renal artery | ||
| 440.20 | Atherosclerosis of native arteries of the extremities, unspecified | ||
| 440.21 | Atherosclerosis of native arteries of the extremities with intermittent claudication | ||
| 440.22 | Atherosclerosis of native arteries of the extremities with rest pain | ||
| 440.23 | Atherosclerosis of native arteries of the extremities with ulceration | ||
| 440.24 | Atherosclerosis of native arteries of the extremities with gangrene | ||
| 440.29 | Other atherosclerosis of native arteries of the extremities | ||
| 440.4 | Chronic total occlusion of artery of the extremities | ||
| 444.0 | Arterial embolism and thrombosis of abdominal aorta | ||
| 444.1 | Embolism and thrombosis of thoracic aorta | ||
| 444.21 | Arterial embolism and thrombosis of upper extremity | ||
| 444.22 | Arterial embolism and thrombosis of lower extremity | ||
| 444.81 | Embolism and thrombosis of iliac artery | ||
| 444.89 | Embolism and thrombosis of other specified artery | ||
| 444.9 | Embolism and thrombosis of unspecified artery | ||
| 445.01 | Atheroembolism of upper extremity | ||
| 445.02 | Atheroembolism of lower extremity | ||
| 445.81 | Atheroembolism of kidney | ||
| 445.89 | Atheroembolism of other site | ||
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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