PQRS Measure
This measure may be submitted via Registry only
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 19125 | Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion | ||
| 19301 | Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); | ||
| 19302 | Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy | ||
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8872 | Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion | ||
| G8873 | 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 | Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion | ||
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast | ||
| C50.012 | Malignant neoplasm of nipple and areola, left female breast | ||
| C50.019 | Malignant neoplasm of nipple and areola, unspecified female breast | ||
| C50.021 | Malignant neoplasm of nipple and areola, right male breast | ||
| C50.022 | Malignant neoplasm of nipple and areola, left male breast | ||
| C50.029 | Malignant neoplasm of nipple and areola, unspecified male breast | ||
| C50.111 | Malignant neoplasm of central portion of right female breast | ||
| C50.112 | Malignant neoplasm of central portion of left female breast | ||
| C50.119 | Malignant neoplasm of central portion of unspecified female breast | ||
| C50.121 | Malignant neoplasm of central portion of right male breast | ||
| C50.122 | Malignant neoplasm of central portion of left male breast | ||
| C50.129 | Malignant neoplasm of central portion of unspecified male breast | ||
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast | ||
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast | ||
| C50.219 | Malignant neoplasm of upper-inner quadrant of unspecified female breast | ||
| C50.221 | Malignant neoplasm of upper-inner quadrant of right male breast | ||
| C50.222 | Malignant neoplasm of upper-inner quadrant of left male breast | ||
| C50.229 | Malignant neoplasm of upper-inner quadrant of unspecified male breast | ||
| C50.311 | Malignant neoplasm of lower-inner quadrant of right female breast | ||
| C50.312 | Malignant neoplasm of lower-inner quadrant of left female breast | ||
| C50.319 | Malignant neoplasm of lower-inner quadrant of unspecified female breast | ||
| C50.321 | Malignant neoplasm of lower-inner quadrant of right male breast | ||
| C50.322 | Malignant neoplasm of lower-inner quadrant of left male breast | ||
| C50.329 | Malignant neoplasm of lower-inner quadrant of unspecified male breast | ||
| C50.411 | Malignant neoplasm of upper-outer quadrant of right female breast | ||
| C50.412 | Malignant neoplasm of upper-outer quadrant of left female breast | ||
| C50.419 | Malignant neoplasm of upper-outer quadrant of unspecified female breast | ||
| C50.421 | Malignant neoplasm of upper-outer quadrant of right male breast | ||
| C50.422 | Malignant neoplasm of upper-outer quadrant of left male breast | ||
| C50.429 | Malignant neoplasm of upper-outer quadrant of unspecified male breast | ||
| C50.511 | Malignant neoplasm of lower-outer quadrant of right female breast | ||
| C50.512 | Malignant neoplasm of lower-outer quadrant of left female breast | ||
| C50.519 | Malignant neoplasm of lower-outer quadrant of unspecified female breast | ||
| C50.521 | Malignant neoplasm of lower-outer quadrant of right male breast | ||
| C50.522 | Malignant neoplasm of lower-outer quadrant of left male breast | ||
| C50.529 | Malignant neoplasm of lower-outer quadrant of unspecified male breast | ||
| C50.611 | Malignant neoplasm of axillary tail of right female breast | ||
| C50.612 | Malignant neoplasm of axillary tail of left female breast | ||
| C50.619 | Malignant neoplasm of axillary tail of unspecified female breast | ||
| C50.621 | Malignant neoplasm of axillary tail of right male breast | ||
| C50.622 | Malignant neoplasm of axillary tail of left male breast | ||
| C50.629 | Malignant neoplasm of axillary tail of unspecified male breast | ||
| C50.811 | Malignant neoplasm of overlapping sites of right female breast | ||
| C50.812 | Malignant neoplasm of overlapping sites of left female breast | ||
| C50.819 | Malignant neoplasm of overlapping sites of unspecified female breast | ||
| C50.821 | Malignant neoplasm of overlapping sites of right male breast | ||
| C50.822 | Malignant neoplasm of overlapping sites of left male breast | ||
| C50.829 | Malignant neoplasm of overlapping sites of unspecified male breast | ||
| C50.911 | Malignant neoplasm of unspecified site of right female breast | ||
| C50.912 | Malignant neoplasm of unspecified site of left female breast | ||
| C50.919 | Malignant neoplasm of unspecified site of unspecified female breast | ||
| C50.921 | Malignant neoplasm of unspecified site of right male breast | ||
| C50.922 | Malignant neoplasm of unspecified site of left male breast | ||
| C50.929 | Malignant neoplasm of unspecified site of unspecified male breast | ||
| C79.81 | Secondary malignant neoplasm of breast | ||
| D24.1 | Benign neoplasm of right breast | ||
| D24.2 | Benign neoplasm of left breast | ||
| D24.9 | Benign neoplasm of unspecified breast | ||
| D49.3 | Neoplasm of unspecified behavior of breast | ||
| N60.01 | Solitary cyst of right breast | ||
| N60.02 | Solitary cyst of left breast | ||
| N60.09 | Solitary cyst of unspecified breast | ||
| N60.11 | Diffuse cystic mastopathy of right breast | ||
| N60.12 | Diffuse cystic mastopathy of left breast | ||
| N60.19 | Diffuse cystic mastopathy of unspecified breast | ||
| N60.21 | Fibroadenosis of right breast | ||
| N60.22 | Fibroadenosis of left breast | ||
| N60.29 | Fibroadenosis of unspecified breast | ||
| N60.31 | Fibrosclerosis of right breast | ||
| N60.32 | Fibrosclerosis of left breast | ||
| N60.39 | Fibrosclerosis of unspecified breast | ||
| N60.41 | Mammary duct ectasia of right breast | ||
| N60.42 | Mammary duct ectasia of left breast | ||
| N60.49 | Mammary duct ectasia of unspecified breast | ||
| N60.81 | Other benign mammary dysplasias of right breast | ||
| N60.82 | Other benign mammary dysplasias of left breast | ||
| N60.89 | Other benign mammary dysplasias of unspecified breast | ||
| N60.91 | Unspecified benign mammary dysplasia of right breast | ||
| N60.92 | Unspecified benign mammary dysplasia of left breast | ||
| N60.99 | Unspecified benign mammary dysplasia of unspecified breast | ||
| N61 | Inflammatory disorders of breast | ||
| N62 | Hypertrophy of breast | ||
| N63 | Unspecified lump in breast | ||
| N64.0 | Fissure and fistula of nipple | ||
| N64.1 | Fat necrosis of breast | ||
| N64.2 | Atrophy of breast | ||
| N64.3 | Galactorrhea not associated with childbirth | ||
| N64.4 | Mastodynia | ||
| N64.51 | Induration of breast | ||
| N64.52 | Nipple discharge | ||
| N64.53 | Retraction of nipple | ||
| N64.59 | Other signs and symptoms in breast | ||
| N64.81 | Ptosis of breast | ||
| N64.82 | Hypoplasia of breast | ||
| N64.89 | Other specified disorders of breast | ||
| N64.89 | Other specified disorders of breast | ||
| N64.9 | Disorder of breast, unspecified | ||
| R92.0 | Mammographic microcalcification found on diagnostic imaging of breast | ||
| R92.1 | Mammographic calcification found on diagnostic imaging of breast | ||
| R92.2 | Inconclusive mammogram | ||
| R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | ||
| T85.44XA | Capsular contracture of breast implant, initial encounter | ||
| T85.44XD | Capsular contracture of breast implant, subsequent encounter | ||
| T85.44XS | Capsular contracture of breast implant, sequela | ||
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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