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PQRS Measure

#23Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
 Description  Data Collection Sheet  Coding Specifications Report via: Claim, Registry, GPRO II, Measure Group
 This measure is can be reported as part of the following groups:
 Perioperative Care Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
4044FDocumentation that an order was given for venous thromboembolism (VTE) prophylaxis to be given within 24 hours prior to incision time or 24 hours after surgery end time (PERI 2)
4044F8PDocumentation that an order was given for venous thromboembolism (VTE) prophylaxis to be given within 24 hours prior to incision time or 24 hours after surgery end time (PERI 2)
4044F1PDocumentation that an order was given for venous thromboembolism (VTE) prophylaxis to be given within 24 hours prior to incision time or 24 hours after surgery end time (PERI 2)
19260Excision of chest wall tumor including ribs
19271Excision of chest wall tumor involving ribs, with plastic reconstruction; without mediastinal lymphadenectomy
19272Excision of chest wall tumor involving ribs, with plastic reconstruction; with mediastinal lymphadenectomy
19301Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
19302Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy
19303Mastectomy, simple, complete
19304Mastectomy, subcutaneous
19305Mastectomy, radical, including pectoral muscles, axillary lymph nodes
19306Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation)
19307Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle
19316Mastopexy
19318Breast reduction
19324Mammaplasty, augmentation; without prosthetic implant
19325Breast augmentation with implant
19328Removal of intact breast implant
19330Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)
19342Insertion or replacement of breast implant on separate day from mastectomy
19350Nipple/areola reconstruction
19355Correction of inverted nipples
19357Tissue expander placement in breast reconstruction, including subsequent expansion(s)
19361Breast reconstruction; with latissimus dorsi flap
19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)
19366Breast reconstruction with other technique
19367Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap
19368Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap, requiring separate microvascular anastomosis (supercharging)
19369Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap
19370Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy
19371Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents
19380Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)
22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar
22600Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment
22612Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)
22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;
27125Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)
27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
27132Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
27134Revision of total hip arthroplasty; both components, with or without autograft or allograft
27137Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
27138Revision of total hip arthroplasty; femoral component only, with or without allograft
27235Percutaneous skeletal fixation of femoral fracture, proximal end, neck
27236Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement
27244Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage
27245Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage
27269Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed
27440Arthroplasty, knee, tibial plateau;
27441Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy
27442Arthroplasty, femoral condyles or tibial plateau(s), knee;
27443Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy
27445Arthroplasty, knee, hinge prosthesis (eg, Walldius type)
27446Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
38100Splenectomy; total (separate procedure)
38101Splenectomy; partial (separate procedure)
38115Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy
38120Laparoscopy, surgical, splenectomy
38571Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
38572Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple
38700Suprahyoid lymphadenectomy
38720Cervical lymphadenectomy (complete)
38724Cervical lymphadenectomy (modified radical neck dissection)
38740Axillary lymphadenectomy; superficial
38745Axillary lymphadenectomy; complete
38747Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure)
38760Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure)
38765Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)
38770Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)
38780Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)
39501Repair, laceration of diaphragm, any approach
39503Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia
39540Repair, diaphragmatic hernia (other than neonatal), traumatic; acute
39541Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic
39545Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic
39560Resection, diaphragm; with simple repair (eg, primary suture)
39561Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)
43020Esophagotomy, cervical approach, with removal of foreign body
43030Cricopharyngeal myotomy
43045Esophagotomy, thoracic approach, with removal of foreign body
43100Excision of lesion, esophagus, with primary repair; cervical approach
43101Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach
43107Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)
43108Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)
43112Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy)
43113Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43116Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction
43117Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor Lewis)
43118Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43121Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty
43122Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty
43123Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43124Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy
43130Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach
43135Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach
43279Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed
43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)
43281Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh
43282Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh
43300Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula
43305Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula
43310Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula
43312Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula
43313Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula
43314Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula
43320Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach
43325Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure)
43327Esophagogastric fundoplasty partial or complete; laparotomy
43328Esophagogastric fundoplasty partial or complete; thoracotomy
43330Esophagomyotomy (Heller type); abdominal approach
43331Esophagomyotomy (Heller type); thoracic approach
43332Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis
43333Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis
43334Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis
43335Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis
43336Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis
43337Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis
43340Esophagojejunostomy (without total gastrectomy); abdominal approach
43341Esophagojejunostomy (without total gastrectomy); thoracic approach
43350Esophagostomy, fistulization of esophagus, external; abdominal approach
43351Esophagostomy, fistulization of esophagus, external; thoracic approach
43352Esophagostomy, fistulization of esophagus, external; cervical approach
43360Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty
43361Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43400Ligation, direct, esophageal varices
43401Transection of esophagus with repair, for esophageal varices
43405Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation
43410Suture of esophageal wound or injury; cervical approach
43415Suture of esophageal wound or injury; transthoracic or transabdominal approach
43420Closure of esophagostomy or fistula; cervical approach
43425Closure of esophagostomy or fistula; transthoracic or transabdominal approach
43496Free jejunum transfer with microvascular anastomosis
43500Gastrotomy; with exploration or foreign body removal
43501Gastrotomy; with suture repair of bleeding ulcer
43502Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss)
43510Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin)
43520Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation)
43605Biopsy of stomach, by laparotomy
43610Excision, local; ulcer or benign tumor of stomach
43611Excision, local; malignant tumor of stomach
43620Gastrectomy, total; with esophagoenterostomy
43621Gastrectomy, total; with Roux-en-Y reconstruction
43622Gastrectomy, total; with formation of intestinal pouch, any type
43631Gastrectomy, partial, distal; with gastroduodenostomy
43632Gastrectomy, partial, distal; with gastrojejunostomy
43633Gastrectomy, partial, distal; with Roux-en-Y reconstruction
43634Gastrectomy, partial, distal; with formation of intestinal pouch
43640Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective
43641Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)
43644Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)
43645Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption
43651Laparoscopy, surgical; transection of vagus nerves, truncal
43652Laparoscopy, surgical; transection of vagus nerves, selective or highly selective
43653Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure)
43770Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)
43771Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only
43772Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only
43773Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only
43774Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components
43775Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)
43800Pyloroplasty
43810Gastroduodenostomy
43820Gastrojejunostomy; without vagotomy
43825Gastrojejunostomy; with vagotomy, any type
43830Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure)
43832Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure)
43840Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury
43843Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty
43845Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)
43846Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy
43847Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption
43848Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)
43850Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy
43855Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; with vagotomy
43860Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy
43865Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy
43870Closure of gastrostomy, surgical
43880Closure of gastrocolic fistula
43886Gastric restrictive procedure, open; revision of subcutaneous port component only
43887Gastric restrictive procedure, open; removal of subcutaneous port component only
43888Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only
44005Enterolysis (freeing of intestinal adhesion) (separate procedure)
44010Duodenotomy, for exploration, biopsy(s), or foreign body removal
44020Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal
44021Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube)
44025Colotomy, for exploration, biopsy(s), or foreign body removal
44050Reduction of volvulus, intussusception, internal hernia, by laparotomy
44055Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure)
44110Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy
44111Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies
44120Enterectomy, resection of small intestine; single resection and anastomosis
44125Enterectomy, resection of small intestine; with enterostomy
44126Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering
44127Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering
44130Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)
44140Colectomy, partial; with anastomosis
44141Colectomy, partial; with skin level cecostomy or colostomy
44143Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure)
44144Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula
44145Colectomy, partial; with coloproctostomy (low pelvic anastomosis)
44146Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy
44147Colectomy, partial; abdominal and transanal approach
44150Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy
44151Colectomy, total, abdominal, without proctectomy; with continent ileostomy
44155Colectomy, total, abdominal, with proctectomy; with ileostomy
44156Colectomy, total, abdominal, with proctectomy; with continent ileostomy
44157Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed
44158Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed
44160Colectomy, partial, with removal of terminal ileum with ileocolostomy
44180Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)
44186Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)
44187Laparoscopy, surgical; ileostomy or jejunostomy, non-tube
44188Laparoscopy, surgical, colostomy or skin level cecostomy
44202Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis
44204Laparoscopy, surgical; colectomy, partial, with anastomosis
44205Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy
44206Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)
44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
44208Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
44210Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy
44211Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed
44212Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy
44227Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis
44300Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)
44310Ileostomy or jejunostomy, non-tube
44312Revision of ileostomy; simple (release of superficial scar) (separate procedure)
44314Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)
44316Continent ileostomy (Kock procedure) (separate procedure)
44320Colostomy or skin level cecostomy;
44322Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)
44340Revision of colostomy; simple (release of superficial scar) (separate procedure)
44345Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)
44346Revision of colostomy; with repair of paracolostomy hernia (separate procedure)
44602Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation
44603Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations
44604Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy
44605Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy
44615Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction
44620Closure of enterostomy, large or small intestine;
44625Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal
44626Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure)
44640Closure of intestinal cutaneous fistula
44650Closure of enteroenteric or enterocolic fistula
44660Closure of enterovesical fistula; without intestinal or bladder resection
44661Closure of enterovesical fistula; with intestine and/or bladder resection
44680Intestinal plication (separate procedure)
44700Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)
44800Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct
44820Excision of lesion of mesentery (separate procedure)
44850Suture of mesentery (separate procedure)
44900Incision and drainage of appendiceal abscess, open
44950Appendectomy;
44960Appendectomy; for ruptured appendix with abscess or generalized peritonitis
44970Laparoscopy, surgical, appendectomy
45000Transrectal drainage of pelvic abscess
45020Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess
45100Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
45108Anorectal myomectomy
45110Proctectomy; complete, combined abdominoperineal, with colostomy
45111Proctectomy; partial resection of rectum, transabdominal approach
45112Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)
45113Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy
45114Proctectomy, partial, with anastomosis; abdominal and transsacral approach
45116Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type)
45119Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed
45120Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation)
45121Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies
45123Proctectomy, partial, without anastomosis, perineal approach
45126Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof
45130Excision of rectal procidentia, with anastomosis; perineal approach
45135Excision of rectal procidentia, with anastomosis; abdominal and perineal approach
45136Excision of ileoanal reservoir with ileostomy
45150Division of stricture of rectum
45160Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach
45171Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)
45172Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)
45190Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach
45395Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy
45397Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when performed
45400Laparoscopy, surgical; proctopexy (for prolapse)
45402Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection
45500Proctoplasty; for stenosis
45505Proctoplasty; for prolapse of mucous membrane
45550Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach
45560Repair of rectocele (separate procedure)
45562Exploration, repair, and presacral drainage for rectal injury;
45563Exploration, repair, and presacral drainage for rectal injury; with colostomy
45800Closure of rectovesical fistula;
45805Closure of rectovesical fistula; with colostomy
45820Closure of rectourethral fistula;
45825Closure of rectourethral fistula; with colostomy
46715Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)
46716Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula
46730Repair of high imperforate anus without fistula; perineal or sacroperineal approach
46735Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches
46740Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach
46742Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches
46744Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach
46746Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;
46748Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps
46750Sphincteroplasty, anal, for incontinence or prolapse; adult
46751Sphincteroplasty, anal, for incontinence or prolapse; child
46753Graft (Thiersch operation) for rectal incontinence and/or prolapse
46754Removal of Thiersch wire or suture, anal canal
46760Sphincteroplasty, anal, for incontinence, adult; muscle transplant
46761Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair)
46762implantation artificial sphincter
47010Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages
47100Biopsy of liver, wedge
47120Hepatectomy, resection of liver; partial lobectomy
47122Hepatectomy, resection of liver; trisegmentectomy
47125Hepatectomy, resection of liver; total left lobectomy
47130Hepatectomy, resection of liver; total right lobectomy
47135Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age
47136Liver allotransplantation; heterotopic, partial or whole, from cadaver or living donor, any age
47140Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III)
47141Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV)
47142Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII)
47300Marsupialization of cyst or abscess of liver
47350Management of liver hemorrhage; simple suture of liver wound or injury
47360Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation
47361Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver
47362Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing
47370Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency
47371Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical
47380Ablation, open, of 1 or more liver tumor(s); radiofrequency
47381Ablation, open, of 1 or more liver tumor(s); cryosurgical
47382Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency
47400Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus
47420Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty
47425Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty
47460Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)
47480Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)
47500Injection procedure for percutaneous transhepatic cholangiography
47505Injection procedure for cholangiography through an existing catheter (eg, percutaneous transhepatic or T-tube)
47560Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy
47561Laparoscopy, surgical; with guided transhepatic cholangiography with biopsy
47562Laparoscopy, surgical; cholecystectomy
47563Laparoscopy, surgical; cholecystectomy with cholangiography
47564Laparoscopy, surgical; cholecystectomy with exploration of common duct
47570Laparoscopy, surgical; cholecystoenterostomy
47600Cholecystectomy;
47605Cholecystectomy; with cholangiography
47610Cholecystectomy with exploration of common duct;
47612Cholecystectomy with exploration of common duct; with choledochoenterostomy
47620Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography
47630Biliary duct stone extraction, percutaneous via T-tube tract, basket, or snare (eg, Burhenne technique)
47700Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography
47701Portoenterostomy (eg, Kasai procedure)
47711Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic
47712Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic
47715Excision of choledochal cyst
47720Cholecystoenterostomy; direct
47721Cholecystoenterostomy; with gastroenterostomy
47740Cholecystoenterostomy; Roux-en-Y
47741Cholecystoenterostomy; Roux-en-Y with gastroenterostomy
47760Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract
47765Anastomosis, of intrahepatic ducts and gastrointestinal tract
47780Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract
47785Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract
47800Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis
47801Placement of choledochal stent
47802U-tube hepaticoenterostomy
47900Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)
48000Placement of drains, peripancreatic, for acute pancreatitis;
48001Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy
48020Removal of pancreatic calculus
48100Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)
48105Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis
48120Excision of lesion of pancreas (eg, cyst, adenoma)
48140Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy
48145Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy
48146Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure)
48148Excision of ampulla of Vater
48150Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy
48152Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy
48153Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy
48154Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy
48155Pancreatectomy, total
48500Marsupialization of pancreatic cyst
48510External drainage, pseudocyst of pancreas, open
48520Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct
48540Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y
48545Pancreatorrhaphy for injury
48547Duodenal exclusion with gastrojejunostomy for pancreatic injury
48548Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation)
48554Transplantation of pancreatic allograft
48556Removal of transplanted pancreatic allograft
49000Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
49002Reopening of recent laparotomy
49010Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)
49020Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open
49040Drainage of subdiaphragmatic or subphrenic abscess, open
49060Drainage of retroperitoneal abscess, open
49203Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less
49204Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter
49205Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter
49215Excision of presacral or sacrococcygeal tumor
49220Staging laparotomy for Hodgkins disease or lymphoma (includes splenectomy, needle or open biopsies of both liver lobes, possibly also removal of abdominal nodes, abdominal node and/or bone marrow biopsies, ovarian repositioning)
49250Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)
49255Omentectomy, epiploectomy, resection of omentum (separate procedure)
49320Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
49321Laparoscopy, surgical; with biopsy (single or multiple)
49322Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)
49323Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity
49560Repair initial incisional or ventral hernia; reducible
49561Repair initial incisional or ventral hernia; incarcerated or strangulated
49565Repair recurrent incisional or ventral hernia; reducible
49566Repair recurrent incisional or ventral hernia; incarcerated or strangulated
49570Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure)
50020Drainage of perirenal or renal abscess, open
50220Nephrectomy, including partial ureterectomy, any open approach including rib resection;
50225Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney
50230Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy
50234Nephrectomy with total ureterectomy and bladder cuff; through same incision
50236Nephrectomy with total ureterectomy and bladder cuff; through separate incision
50240Nephrectomy, partial
50320Donor nephrectomy (including cold preservation); open, from living donor
50340Recipient nephrectomy (separate procedure)
50360Renal allotransplantation, implantation of graft; without recipient nephrectomy
50365Renal allotransplantation, implantation of graft; with recipient nephrectomy
50370Removal of transplanted renal allograft
50380Renal autotransplantation, reimplantation of kidney
50543Laparoscopy, surgical; partial nephrectomy
50545Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)
50546Laparoscopy, surgical; nephrectomy, including partial ureterectomy
50547Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor
50548Laparoscopy, surgical; nephrectomy with total ureterectomy
50715Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis
50722Ureterolysis for ovarian vein syndrome
50725Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava
50727Revision of urinary-cutaneous anastomosis (any type urostomy);
50728Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia
50760Ureteroureterostomy
50770Transureteroureterostomy, anastomosis of ureter to contralateral ureter
50780Ureteroneocystostomy; anastomosis of single ureter to bladder
50782Ureteroneocystostomy; anastomosis of duplicated ureter to bladder
50783Ureteroneocystostomy; with extensive ureteral tailoring
50785Ureteroneocystostomy; with vesico-psoas hitch or bladder flap
50800Ureteroenterostomy, direct anastomosis of ureter to intestine
50810Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis
50815Ureterocolon conduit, including intestine anastomosis
50820Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation)
50947Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement
50948Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement
51550Cystectomy, partial; simple
51555Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)
51565Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)
51570Cystectomy, complete; (separate procedure)
51575Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51580Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;
51585Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51590Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;
51595Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51596Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder
51597Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
51800Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck
51820Cystourethroplasty with unilateral or bilateral ureteroneocystostomy
51900Closure of vesicovaginal fistula, abdominal approach
51920Closure of vesicouterine fistula;
51925Closure of vesicouterine fistula; with hysterectomy
51960Enterocystoplasty, including intestinal anastomosis
55810Prostatectomy, perineal radical;
55812Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55815Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
55821Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages
55831Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal
55840Prostatectomy, retropubic radical, with or without nerve sparing;
55842Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55845Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed
56630Vulvectomy, radical, partial;
56631Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy
56632Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy
56633Vulvectomy, radical, complete;
56634Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy
56637Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy
56640Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy
58200Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)
58210Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)
58240Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
58285Vaginal hysterectomy, radical (Schauta type operation)
58951Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy
58953Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;
58954Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
58956Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy
60200Excision of cyst or adenoma of thyroid, or transection of isthmus
60210Partial thyroid lobectomy, unilateral; with or without isthmusectomy
60212Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
60220Total thyroid lobectomy, unilateral; with or without isthmusectomy
60225Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
60240Thyroidectomy, total or complete
60252Thyroidectomy, total or subtotal for malignancy; with limited neck dissection
60254Thyroidectomy, total or subtotal for malignancy; with radical neck dissection
60260Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid
60270Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach
60271Thyroidectomy, including substernal thyroid; cervical approach
60280Excision of thyroglossal duct cyst or sinus;
60281Excision of thyroglossal duct cyst or sinus; recurrent
60500Parathyroidectomy or exploration of parathyroid(s);
60502Parathyroidectomy or exploration of parathyroid(s); re-exploration
60505Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach
60520Thymectomy, partial or total; transcervical approach (separate procedure)
60521Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)
60522Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)
60540Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);
60545Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor
60600Excision of carotid body tumor; without excision of carotid artery
60605Excision of carotid body tumor; with excision of carotid artery
60650Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal
61313Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral
61510Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma
61512Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial
61518Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
61548Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
61697Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation
61700Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
62230Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system
63015Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical
63020Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical
63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar
63056Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)
63081Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment
63267Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar
63276Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic
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 IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.

More information on these alternative reporting mechanisms is available at:
    http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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