PQRS Information

Year: 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007

PQRS Measure

#226Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Report via: Claim, Registry, EHR, GPRO/ACO, Measure Group

This measure is can be reported as part of the following groups:
• Diabetes Mellitus Group
• Chronic Kidney Disease (CKD) Group
• Preventive Care Group
• Hepatitis C Group
• Heart Failure (HF) Group
• Coronary Artery Disease (CAD) Group
• HIV/AIDS Group
• Asthma Group
• Chronic Obstructive Pulmonary Disease (COPD) Group
• Inflammatory Bowel Disease (IBD) Group
• Sleep Apnea Group
• Cataracts Group
• Oncology Group
• Total Knee Replacement Group
• General Surgery Group
• Sinusitis Group
• Acute Otitis Externa (AOE) Group

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
90791			Psychiatric diagnostic evaluation
90792			Psychiatric diagnostic evaluation with medical services
90832			Psychotherapy, 30 minutes with patient
90834			Psychotherapy, 45 minutes with patient
90837			Psychotherapy, 60 minutes with patient
90845			Psychoanalysis
92002			Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004			Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012			Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014			Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
96150			Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
96151			Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment
96152			Health and behavior intervention, each 15 minutes, face-to-face; individual
97003			Occupational therapy evaluation
97004			Occupational therapy re-evaluation
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.
99406			Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
99407			Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
1036F			Current tobacco non-user (CAD, CAP, COPD, PV) (DM) (IBD)
1036F			Current tobacco non-user (CAD, CAP, COPD, PV) (DM) (IBD)
4004F	8P		Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)
4004F			Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)
4004F	1P		Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)
4004F			Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)
4004F	8P		Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)
HCPCS Codes
Code	Modifier	POS	Description
G0438			Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439			Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

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).
GPROThis 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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