PQRS Measure
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 99281 | 23 | Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional | |
| 99282 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making | |
| 99283 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making | |
| 99284 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making | |
| 99285 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making | |
| 99291 | 23 | Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | |
| 99281 | 23 | Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional | |
| 99282 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making | |
| 99283 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making | |
| 99284 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making | |
| 99285 | 23 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making | |
| 99291 | 23 | Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8806 | Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented | ||
| G8806 | Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented | ||
| G8807 | Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has a documented intrauterine pregnancy [iup]) | ||
| G8808 | Trans-abdominal or trans-vaginal ultrasound not performed, reason not given | ||
| G8808 | Trans-abdominal or trans-vaginal ultrasound not performed, reason not given | ||
| G8806 | Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented | ||
| G8806 | Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented | ||
| G8807 | Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has a documented intrauterine pregnancy [iup]) | ||
| G8808 | Trans-abdominal or trans-vaginal ultrasound not performed, reason not given | ||
| G8808 | Trans-abdominal or trans-vaginal ultrasound not performed, reason not given | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 648.90 | Other current conditions classifiable elsewhere of mother, unspecified as to episode of care or not applicable | ||
| 648.93 | Other current conditions classifiable elsewhere of mother, antepartum condition or complication | ||
| 789.00 | Abdominal pain, unspecified site | ||
| 789.03 | Abdominal pain, right lower quadrant | ||
| 789.04 | Abdominal pain, left lower quadrant | ||
| 789.05 | Abdominal pain, periumbilic | ||
| 789.06 | Abdominal pain, epigastric | ||
| 789.07 | Abdominal pain, generalized | ||
| 789.09 | Abdominal pain, other specified site | ||
| 789.60 | Abdominal tenderness, unspecified site | ||
| 789.63 | Abdominal tenderness, right lower quadrant | ||
| 789.64 | Abdominal tenderness, left lower quadrant | ||
| 789.65 | Abdominal tenderness, periumbilic | ||
| 789.66 | Abdominal tenderness, epigastric | ||
| 789.67 | Abdominal tenderness, generalized | ||
| 789.69 | Abdominal tenderness, other specified site | ||
| 640.00 | Threatened abortion, unspecified as to episode of care or not applicable | ||
| 640.03 | Threatened abortion, antepartum condition or complication | ||
| 640.80 | Other specified hemorrhage in early pregnancy, unspecified as to episode of care or not applicable | ||
| 640.83 | Other specified hemorrhage in early pregnancy, antepartum condition or complication | ||
| 640.90 | Unspecified hemorrhage in early pregnancy, unspecified as to episode of care or not applicable | ||
| 640.93 | Unspecified hemorrhage in early pregnancy, antepartum condition or complication | ||
| 641.10 | Hemorrhage from placenta previa, unspecified as to episode of care or not applicable | ||
| 641.13 | Hemorrhage from placenta previa, antepartum condition or complication | ||
| 641.20 | Premature separation of placenta, unspecified as to episode of care or not applicable | ||
| 641.23 | Premature separation of placenta, antepartum condition or complication | ||
| 641.30 | Antepartum hemorrhage associated with coagulation defects, unspecified as to episode of care or not applicable | ||
| 641.33 | Antepartum hemorrhage associated with coagulation defects, antepartum condition or complication | ||
| 641.80 | Other antepartum hemorrhage, unspecified as to episode of care or not applicable | ||
| 641.83 | Other antepartum hemorrhage, antepartum condition or complication | ||
| 641.90 | Unspecified antepartum hemorrhage, unspecified as to episode of care or not applicable | ||
| 641.93 | Unspecified antepartum hemorrhage, antepartum condition or complication | ||
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| O26.899 | Other specified pregnancy related conditions, unspecified trimester | ||
| O26.90 | Pregnancy related conditions, unspecified, unspecified trimester | ||
| O26.91 | Pregnancy related conditions, unspecified, first trimester | ||
| R10.0 | Acute abdomen | ||
| R10.10 | Upper abdominal pain, unspecified | ||
| R10.13 | Epigastric pain | ||
| R10.2 | Pelvic and perineal pain | ||
| R10.30 | Lower abdominal pain, unspecified | ||
| R10.31 | Right lower quadrant pain | ||
| R10.32 | Left lower quadrant pain | ||
| R10.33 | Periumbilical pain | ||
| R10.813 | Right lower quadrant abdominal tenderness | ||
| R10.814 | Left lower quadrant abdominal tenderness | ||
| R10.815 | Periumbilic abdominal tenderness | ||
| R10.816 | Epigastric abdominal tenderness | ||
| R10.817 | Generalized abdominal tenderness | ||
| R10.819 | Abdominal tenderness, unspecified site | ||
| R10.823 | Right lower quadrant rebound abdominal tenderness | ||
| R10.824 | Left lower quadrant rebound abdominal tenderness | ||
| R10.825 | Periumbilic rebound abdominal tenderness | ||
| R10.826 | Epigastric rebound abdominal tenderness | ||
| R10.827 | Generalized rebound abdominal tenderness | ||
| R10.829 | Rebound abdominal tenderness, unspecified site | ||
| R10.84 | Generalized abdominal pain | ||
| R10.9 | Unspecified abdominal pain | ||
| O20.0 | Threatened abortion | ||
| O20.8 | Other hemorrhage in early pregnancy | ||
| O20.9 | Hemorrhage in early pregnancy, unspecified | ||
| O44.10 | Complete placenta previa with hemorrhage, unspecified trimester | ||
| O44.11 | Complete placenta previa with hemorrhage, first trimester | ||
| O45.001 | Premature separation of placenta with coagulation defect, unspecified, first trimester | ||
| O45.009 | Premature separation of placenta with coagulation defect, unspecified, unspecified trimester | ||
| O45.011 | Premature separation of placenta with afibrinogenemia, first trimester | ||
| O45.019 | Premature separation of placenta with afibrinogenemia, unspecified trimester | ||
| O45.021 | Premature separation of placenta with disseminated intravascular coagulation, first trimester | ||
| O45.029 | Premature separation of placenta with disseminated intravascular coagulation, unspecified trimester | ||
| O45.091 | Premature separation of placenta with other coagulation defect, first trimester | ||
| O45.099 | Premature separation of placenta with other coagulation defect, unspecified trimester | ||
| O45.8X1 | Other premature separation of placenta, first trimester | ||
| O45.8X9 | Other premature separation of placenta, unspecified trimester | ||
| O45.90 | Premature separation of placenta, unspecified, unspecified trimester | ||
| O45.91 | Premature separation of placenta, unspecified, first trimester | ||
| O46.001 | Antepartum hemorrhage with coagulation defect, unspecified, first trimester | ||
| O46.009 | Antepartum hemorrhage with coagulation defect, unspecified, unspecified trimester | ||
| O46.011 | Antepartum hemorrhage with afibrinogenemia, first trimester | ||
| O46.019 | Antepartum hemorrhage with afibrinogenemia, unspecified trimester | ||
| O46.021 | Antepartum hemorrhage with disseminated intravascular coagulation, first trimester | ||
| O46.029 | Antepartum hemorrhage with disseminated intravascular coagulation, unspecified trimester | ||
| O46.091 | Antepartum hemorrhage with other coagulation defect, first trimester | ||
| O46.8X1 | Other antepartum hemorrhage, first trimester | ||
| O46.8X9 | Other antepartum hemorrhage, unspecified trimester | ||
| O46.90 | Antepartum hemorrhage, unspecified, unspecified trimester | ||
| O46.91 | Antepartum hemorrhage, unspecified, first trimester | ||
| O46.099 | Antepartum hemorrhage with other coagulation defect, unspecified trimester | ||
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.
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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