PQRS Information

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

PQRS Measure

#262Image Confirmation of Successful Excision of Image-Localized Breast Lesion

Report via: Claim, Registry

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
19125	N/A	N/A	Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion
19301	N/A	N/A	Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
19302	N/A	N/A	Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy
HCPCS Codes
Code	Modifier	POS	Description
G8872	N/A	N/A	Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
G8873	N/A	N/A	Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)
G8874	N/A	N/A	Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion
ICD9 Codes
Code	Modifier	POS	Description
174.0	N/A	N/A	Malignant neoplasm of nipple and areola of female breast
174.1	N/A	N/A	Malignant neoplasm of central portion of female breast
174.2	N/A	N/A	Malignant neoplasm of upper-inner quadrant of female breast
174.3	N/A	N/A	Malignant neoplasm of lower-inner quadrant of female breast
174.4	N/A	N/A	Malignant neoplasm of upper-outer quadrant of female breast
174.5	N/A	N/A	Malignant neoplasm of lower-outer quadrant of female breast
174.6	N/A	N/A	Malignant neoplasm of axillary tail of female breast
174.8	N/A	N/A	Malignant neoplasm of other specified sites of female breast
174.9	N/A	N/A	Malignant neoplasm of breast (female), unspecified
175.0	N/A	N/A	Malignant neoplasm of nipple and areola of male breast
175.9	N/A	N/A	Malignant neoplasm of other and unspecified sites of male breast
198.81	N/A	N/A	Secondary malignant neoplasm of breast
217	N/A	N/A	Benign neoplasm of breast
239.3	N/A	N/A	Neoplasm of unspecified nature of breast
610.0	N/A	N/A	Solitary cyst of breast
610.1	N/A	N/A	Diffuse cystic mastopathy
610.2	N/A	N/A	Fibroadenosis of breast
610.3	N/A	N/A	Fibrosclerosis of breast
610.4	N/A	N/A	Mammary duct ectasia
610.8	N/A	N/A	Other specified benign mammary dysplasias
610.9	N/A	N/A	Benign mammary dysplasia, unspecified
611.0	N/A	N/A	Inflammatory disease of breast
611.1	N/A	N/A	Hypertrophy of breast
611.2	N/A	N/A	Fissure of nipple
611.3	N/A	N/A	Fat necrosis of breast
611.4	N/A	N/A	Atrophy of breast
611.5	N/A	N/A	Galactocele
611.6	N/A	N/A	Galactorrhea not associated with childbirth
611.71	N/A	N/A	Mastodynia
611.72	N/A	N/A	Lump or mass in breast
611.79	N/A	N/A	Other signs and symptoms in breast
611.81	N/A	N/A	Ptosis of breast
611.82	N/A	N/A	Hypoplasia of breast
611.83	N/A	N/A	Capsular contracture of breast implant
611.89	N/A	N/A	Other specified disorders of breast
611.9	N/A	N/A	Unspecified breast disorder
793.80	N/A	N/A	Abnormal mammogram, unspecified
793.81	N/A	N/A	Mammographic microcalcification
793.82	N/A	N/A	Inconclusive mammogram
793.89	N/A	N/A	Other (abnormal) findings on radiological examination of breast
ICD10CM Codes
Code	Modifier	POS	Description
C50.011	N/A	N/A	Malignant neoplasm of nipple and areola, right female breast
C50.012	N/A	N/A	Malignant neoplasm of nipple and areola, left female breast
C50.019	N/A	N/A	Malignant neoplasm of nipple and areola, unspecified female breast
C50.021	N/A	N/A	Malignant neoplasm of nipple and areola, right male breast
C50.022	N/A	N/A	Malignant neoplasm of nipple and areola, left male breast
C50.029	N/A	N/A	Malignant neoplasm of nipple and areola, unspecified male breast
C50.111	N/A	N/A	Malignant neoplasm of central portion of right female breast
C50.112	N/A	N/A	Malignant neoplasm of central portion of left female breast
C50.119	N/A	N/A	Malignant neoplasm of central portion of unspecified female breast
C50.121	N/A	N/A	Malignant neoplasm of central portion of right male breast
C50.122	N/A	N/A	Malignant neoplasm of central portion of left male breast
C50.129	N/A	N/A	Malignant neoplasm of central portion of unspecified male breast
C50.211	N/A	N/A	Malignant neoplasm of upper-inner quadrant of right female breast
C50.212	N/A	N/A	Malignant neoplasm of upper-inner quadrant of left female breast
C50.219	N/A	N/A	Malignant neoplasm of upper-inner quadrant of unspecified female breast
C50.221	N/A	N/A	Malignant neoplasm of upper-inner quadrant of right male breast
C50.222	N/A	N/A	Malignant neoplasm of upper-inner quadrant of left male breast
C50.229	N/A	N/A	Malignant neoplasm of upper-inner quadrant of unspecified male breast
C50.311	N/A	N/A	Malignant neoplasm of lower-inner quadrant of right female breast
C50.312	N/A	N/A	Malignant neoplasm of lower-inner quadrant of left female breast
C50.319	N/A	N/A	Malignant neoplasm of lower-inner quadrant of unspecified female breast
C50.321	N/A	N/A	Malignant neoplasm of lower-inner quadrant of right male breast
C50.322	N/A	N/A	Malignant neoplasm of lower-inner quadrant of left male breast
C50.329	N/A	N/A	Malignant neoplasm of lower-inner quadrant of unspecified male breast
C50.411	N/A	N/A	Malignant neoplasm of upper-outer quadrant of right female breast
C50.412	N/A	N/A	Malignant neoplasm of upper-outer quadrant of left female breast
C50.419	N/A	N/A	Malignant neoplasm of upper-outer quadrant of unspecified female breast
C50.421	N/A	N/A	Malignant neoplasm of upper-outer quadrant of right male breast
C50.422	N/A	N/A	Malignant neoplasm of upper-outer quadrant of left male breast
C50.429	N/A	N/A	Malignant neoplasm of upper-outer quadrant of unspecified male breast
C50.511	N/A	N/A	Malignant neoplasm of lower-outer quadrant of right female breast
C50.512	N/A	N/A	Malignant neoplasm of lower-outer quadrant of left female breast
C50.519	N/A	N/A	Malignant neoplasm of lower-outer quadrant of unspecified female breast
C50.521	N/A	N/A	Malignant neoplasm of lower-outer quadrant of right male breast
C50.522	N/A	N/A	Malignant neoplasm of lower-outer quadrant of left male breast
C50.529	N/A	N/A	Malignant neoplasm of lower-outer quadrant of unspecified male breast
C50.611	N/A	N/A	Malignant neoplasm of axillary tail of right female breast
C50.612	N/A	N/A	Malignant neoplasm of axillary tail of left female breast
C50.619	N/A	N/A	Malignant neoplasm of axillary tail of unspecified female breast
C50.621	N/A	N/A	Malignant neoplasm of axillary tail of right male breast
C50.622	N/A	N/A	Malignant neoplasm of axillary tail of left male breast
C50.629	N/A	N/A	Malignant neoplasm of axillary tail of unspecified male breast
C50.811	N/A	N/A	Malignant neoplasm of overlapping sites of right female breast
C50.812	N/A	N/A	Malignant neoplasm of overlapping sites of left female breast
C50.819	N/A	N/A	Malignant neoplasm of overlapping sites of unspecified female breast
C50.821	N/A	N/A	Malignant neoplasm of overlapping sites of right male breast
C50.822	N/A	N/A	Malignant neoplasm of overlapping sites of left male breast
C50.829	N/A	N/A	Malignant neoplasm of overlapping sites of unspecified male breast
C50.911	N/A	N/A	Malignant neoplasm of unspecified site of right female breast
C50.912	N/A	N/A	Malignant neoplasm of unspecified site of left female breast
C50.919	N/A	N/A	Malignant neoplasm of unspecified site of unspecified female breast
C50.921	N/A	N/A	Malignant neoplasm of unspecified site of right male breast
C50.922	N/A	N/A	Malignant neoplasm of unspecified site of left male breast
C50.929	N/A	N/A	Malignant neoplasm of unspecified site of unspecified male breast
C79.81	N/A	N/A	Secondary malignant neoplasm of breast
D24.1	N/A	N/A	Benign neoplasm of right breast
D24.2	N/A	N/A	Benign neoplasm of left breast
D24.9	N/A	N/A	Benign neoplasm of unspecified breast
D49.3	N/A	N/A	Neoplasm of unspecified behavior of breast
N60.01	N/A	N/A	Solitary cyst of right breast
N60.02	N/A	N/A	Solitary cyst of left breast
N60.09	N/A	N/A	Solitary cyst of unspecified breast
N60.11	N/A	N/A	Diffuse cystic mastopathy of right breast
N60.12	N/A	N/A	Diffuse cystic mastopathy of left breast
N60.19	N/A	N/A	Diffuse cystic mastopathy of unspecified breast
N60.21	N/A	N/A	Fibroadenosis of right breast
N60.22	N/A	N/A	Fibroadenosis of left breast
N60.29	N/A	N/A	Fibroadenosis of unspecified breast
N60.31	N/A	N/A	Fibrosclerosis of right breast
N60.32	N/A	N/A	Fibrosclerosis of left breast
N60.39	N/A	N/A	Fibrosclerosis of unspecified breast
N60.41	N/A	N/A	Mammary duct ectasia of right breast
N60.42	N/A	N/A	Mammary duct ectasia of left breast
N60.49	N/A	N/A	Mammary duct ectasia of unspecified breast
N60.81	N/A	N/A	Other benign mammary dysplasias of right breast
N60.82	N/A	N/A	Other benign mammary dysplasias of left breast
N60.89	N/A	N/A	Other benign mammary dysplasias of unspecified breast
N60.91	N/A	N/A	Unspecified benign mammary dysplasia of right breast
N60.92	N/A	N/A	Unspecified benign mammary dysplasia of left breast
N60.99	N/A	N/A	Unspecified benign mammary dysplasia of unspecified breast
N61	N/A	N/A	Inflammatory disorders of breast
N62	N/A	N/A	Hypertrophy of breast
N64.0	N/A	N/A	Fissure and fistula of nipple
N64.1	N/A	N/A	Fat necrosis of breast
N64.2	N/A	N/A	Atrophy of breast
N64.89	N/A	N/A	Other specified disorders of breast
N64.3	N/A	N/A	Galactorrhea not associated with childbirth
N64.4	N/A	N/A	Mastodynia
N63	N/A	N/A	Unspecified lump in breast
N64.51	N/A	N/A	Induration of breast
N64.52	N/A	N/A	Nipple discharge
N64.53	N/A	N/A	Retraction of nipple
N64.59	N/A	N/A	Other signs and symptoms in breast
N64.81	N/A	N/A	Ptosis of breast
N64.82	N/A	N/A	Hypoplasia of breast
T85.44	N/A	N/A
T85.44XA	N/A	N/A	Capsular contracture of breast implant, initial encounter
T85.44XD	N/A	N/A	Capsular contracture of breast implant, subsequent encounter
T85.44XS	N/A	N/A	Capsular contracture of breast implant, sequela
N64.9	N/A	N/A	Disorder of breast, unspecified
R92.8	N/A	N/A	Other abnormal and inconclusive findings on diagnostic imaging of breast
R92.0	N/A	N/A	Mammographic microcalcification found on diagnostic imaging of breast
R92.1	N/A	N/A	Mammographic calcification found on diagnostic imaging of breast
R92.2	N/A	N/A	Inconclusive mammogram

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.

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

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PQRS Measure

CPT Codes

HCPCS Codes

ICD9 Codes

ICD10CM Codes