PQRS Measure
#263Preoperative Diagnosis of Breast Cancer
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 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 |
| 19303 | N/A | N/A | Mastectomy, simple, complete |
| 19307 | N/A | N/A | Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle |
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8875 | N/A | N/A | Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method |
| G8876 | N/A | N/A | Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician) |
| G8877 | N/A | N/A | Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given |
| G8875 | N/A | N/A | Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method |
| G8877 | N/A | N/A | Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given |
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 |
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.
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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