PQRS Information

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

PQRS Measure

#255Rh Immunoglobulin (Rhogam) for Rh-Negative Pregnant Women at Risk of Fetal Blood Exposure

Report via: Claim, Registry

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
99281	N/A	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	N/A	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	N/A	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	N/A	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	N/A	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	N/A	23	Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
HCPCS Codes
Code	Modifier	POS	Description
G8809	N/A	N/A	Rh-immunoglobulin (rhogam) ordered
G8809	N/A	N/A	Rh-immunoglobulin (rhogam) ordered
G8810	N/A	N/A	Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)
G8811	N/A	N/A	Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
G8811	N/A	N/A	Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given
ICD9 Codes
Code	Modifier	POS	Description
632	N/A	N/A	Missed abortion
633.80	N/A	N/A	Other ectopic pregnancy without intrauterine pregnancy
633.81	N/A	N/A	Other ectopic pregnancy with intrauterine pregnancy
633.90	N/A	N/A	Unspecified ectopic pregnancy without intrauterine pregnancy
633.91	N/A	N/A	Unspecified ectopic pregnancy with intrauterine pregnancy
634.10	N/A	N/A	Spontaneous abortion, complicated by delayed or excessive hemorrhage, unspecified
634.11	N/A	N/A	Spontaneous abortion, complicated by delayed or excessive hemorrhage, incomplete
634.12	N/A	N/A	Spontaneous abortion, complicated by delayed or excessive hemorrhage, complete
636.10	N/A	N/A	Illegally induced abortion, complicated by delayed or excessive hemorrhage, unspecified
636.11	N/A	N/A	Illegally induced abortion, complicated by delayed or excessive hemorrhage, incomplete
636.12	N/A	N/A	Illegally induced abortion, complicated by delayed or excessive hemorrhage, complete
637.10	N/A	N/A	Unspecified abortion, complicated by delayed or excessive hemorrhage, unspecified
637.11	N/A	N/A	Unspecified abortion, complicated by delayed or excessive hemorrhage, incomplete
637.12	N/A	N/A	Unspecified abortion, complicated by delayed or excessive hemorrhage, complete
638.1	N/A	N/A	Failed attempted abortion complicated by delayed or excessive hemorrhage
639.1	N/A	N/A	Delayed or excessive hemorrhage following abortion or ectopic and molar pregnancies
640.00	N/A	N/A	Threatened abortion, unspecified as to episode of care or not applicable
640.03	N/A	N/A	Threatened abortion, antepartum condition or complication
640.80	N/A	N/A	Other specified hemorrhage in early pregnancy, unspecified as to episode of care or not applicable
640.83	N/A	N/A	Other specified hemorrhage in early pregnancy, antepartum condition or complication
640.90	N/A	N/A	Unspecified hemorrhage in early pregnancy, unspecified as to episode of care or not applicable
640.93	N/A	N/A	Unspecified hemorrhage in early pregnancy, antepartum condition or complication
641.10	N/A	N/A	Hemorrhage from placenta previa, unspecified as to episode of care or not applicable
641.13	N/A	N/A	Hemorrhage from placenta previa, antepartum condition or complication
641.20	N/A	N/A	Premature separation of placenta, unspecified as to episode of care or not applicable
641.23	N/A	N/A	Premature separation of placenta, antepartum condition or complication
641.30	N/A	N/A	Antepartum hemorrhage associated with coagulation defects, unspecified as to episode of care or not applicable
641.33	N/A	N/A	Antepartum hemorrhage associated with coagulation defects, antepartum condition or complication
641.80	N/A	N/A	Other antepartum hemorrhage, unspecified as to episode of care or not applicable
641.83	N/A	N/A	Other antepartum hemorrhage, antepartum condition or complication
641.90	N/A	N/A	Unspecified antepartum hemorrhage, unspecified as to episode of care or not applicable
641.93	N/A	N/A	Unspecified antepartum hemorrhage, antepartum condition or complication
656.00	N/A	N/A	Fetal-maternal hemorrhage, unspecified as to episode of care or not applicable
656.03	N/A	N/A	Fetal-maternal hemorrhage, antepartum condition or complication
656.10	N/A	N/A	Rhesus isoimmunization, unspecified as to episode of care or not applicable
656.13	N/A	N/A	Rhesus isoimmunization, antepartum condition or complication
ICD10CM Codes
Code	Modifier	POS	Description
O00.8	N/A	N/A	Other ectopic pregnancy
O00.9	N/A	N/A	Ectopic pregnancy, unspecified
O02.1	N/A	N/A	Missed abortion
O03.1	N/A	N/A	Delayed or excessive hemorrhage following incomplete spontaneous abortion
O03.6	N/A	N/A	Delayed or excessive hemorrhage following complete or unspecified spontaneous abortion
O04.6	N/A	N/A	Delayed or excessive hemorrhage following (induced) termination of pregnancy
O07.1	N/A	N/A	Delayed or excessive hemorrhage following failed attempted termination of pregnancy
O08.1	N/A	N/A	Delayed or excessive hemorrhage following ectopic and molar pregnancy
O20.0	N/A	N/A	Threatened abortion
O20.8	N/A	N/A	Other hemorrhage in early pregnancy
O20.9	N/A	N/A	Hemorrhage in early pregnancy, unspecified
O36.0110	N/A	N/A	Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified
O36.0111	N/A	N/A	Maternal care for anti-D [Rh] antibodies, first trimester, fetus 1
O36.0190	N/A	N/A	Maternal care for anti-D [Rh] antibodies, unspecified trimester, not applicable or unspecified
O36.0191	N/A	N/A	Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 1
O36.0910	N/A	N/A	Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified
O36.0911	N/A	N/A	Maternal care for other rhesus isoimmunization, first trimester, fetus 1
O36.0990	N/A	N/A	Maternal care for other rhesus isoimmunization, unspecified trimester, not applicable or unspecified
O36.0991	N/A	N/A	Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 1
O43.011	N/A	N/A	Fetomaternal placental transfusion syndrome, first trimester
O43.019	N/A	N/A	Fetomaternal placental transfusion syndrome, unspecified trimester
O44.10	N/A	N/A	Complete placenta previa with hemorrhage, unspecified trimester
O44.11	N/A	N/A	Complete placenta previa with hemorrhage, first trimester
O45.001	N/A	N/A	Premature separation of placenta with coagulation defect, unspecified, first trimester
O45.009	N/A	N/A	Premature separation of placenta with coagulation defect, unspecified, unspecified trimester
O45.011	N/A	N/A	Premature separation of placenta with afibrinogenemia, first trimester
O45.019	N/A	N/A	Premature separation of placenta with afibrinogenemia, unspecified trimester
O45.021	N/A	N/A	Premature separation of placenta with disseminated intravascular coagulation, first trimester
O45.029	N/A	N/A	Premature separation of placenta with disseminated intravascular coagulation, unspecified trimester
O45.091	N/A	N/A	Premature separation of placenta with other coagulation defect, first trimester
O45.099	N/A	N/A	Premature separation of placenta with other coagulation defect, unspecified trimester
O45.8X1	N/A	N/A	Other premature separation of placenta, first trimester
O45.8X9	N/A	N/A	Other premature separation of placenta, unspecified trimester
O45.90	N/A	N/A	Premature separation of placenta, unspecified, unspecified trimester
O45.91	N/A	N/A	Premature separation of placenta, unspecified, first trimester
O46.001	N/A	N/A	Antepartum hemorrhage with coagulation defect, unspecified, first trimester
O46.011	N/A	N/A	Antepartum hemorrhage with afibrinogenemia, first trimester
O46.021	N/A	N/A	Antepartum hemorrhage with disseminated intravascular coagulation, first trimester
O46.8X1	N/A	N/A	Other antepartum hemorrhage, first trimester
O46.8X9	N/A	N/A	Other antepartum hemorrhage, unspecified trimester
O46.90	N/A	N/A	Antepartum hemorrhage, unspecified, unspecified trimester
O46.91	N/A	N/A	Antepartum hemorrhage, unspecified, first 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).
GPRO/ACOThis 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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