PQRS Information

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

PQRS Measure

#265Biopsy Follow-Up

This measure may be submitted via Registry only

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
11100	N/A	N/A	Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion
11755	N/A	N/A	Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)
19100	N/A	N/A	Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)
19101	N/A	N/A	Biopsy of breast; open, incisional
19102	N/A	N/A	Biopsy of breast; percutaneous, needle core, using imaging guidance
19103	N/A	N/A	Biopsy of breast; percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance
19125	N/A	N/A	Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion
20200	N/A	N/A	Biopsy, muscle; superficial
20205	N/A	N/A	Biopsy, muscle; deep
20206	N/A	N/A	Biopsy, muscle, percutaneous needle
20220	N/A	N/A	Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
20225	N/A	N/A	Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
20240	N/A	N/A	Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
20245	N/A	N/A	Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)
20250	N/A	N/A	Biopsy, vertebral body, open; thoracic
20251	N/A	N/A	Biopsy, vertebral body, open; lumbar or cervical
21550	N/A	N/A	Biopsy, soft tissue of neck or thorax
21920	N/A	N/A	Biopsy, soft tissue of back or flank; superficial
21925	N/A	N/A	Biopsy, soft tissue of back or flank; deep
23065	N/A	N/A	Biopsy, soft tissue of shoulder area; superficial
23066	N/A	N/A	Biopsy, soft tissue of shoulder area; deep
23100	N/A	N/A	Arthrotomy, glenohumeral joint, including biopsy
23101	N/A	N/A	Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage
24065	N/A	N/A	Biopsy, soft tissue of upper arm or elbow area; superficial
24066	N/A	N/A	Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)
24100	N/A	N/A	Arthrotomy, elbow; with synovial biopsy only
24101	N/A	N/A	Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body
25065	N/A	N/A	Biopsy, soft tissue of forearm and/or wrist; superficial
25066	N/A	N/A	Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)
25100	N/A	N/A	Arthrotomy, wrist joint; with biopsy
25101	N/A	N/A	Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body
26100	N/A	N/A	Arthrotomy with biopsy; carpometacarpal joint, each
26105	N/A	N/A	Arthrotomy with biopsy; metacarpophalangeal joint, each
26110	N/A	N/A	Arthrotomy with biopsy; interphalangeal joint, each
27040	N/A	N/A	Biopsy, soft tissue of pelvis and hip area; superficial
27041	N/A	N/A	Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular
27050	N/A	N/A	Arthrotomy, with biopsy; sacroiliac joint
27052	N/A	N/A	Arthrotomy, with biopsy; hip joint
27323	N/A	N/A	Biopsy, soft tissue of thigh or knee area; superficial
27324	N/A	N/A	Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)
27330	N/A	N/A	Arthrotomy, knee; with synovial biopsy only
27331	N/A	N/A	Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies
27613	N/A	N/A	Biopsy, soft tissue of leg or ankle area; superficial
27614	N/A	N/A	Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)
27620	N/A	N/A	Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body
28050	N/A	N/A	Arthrotomy with biopsy; intertarsal or tarsometatarsal joint
28052	N/A	N/A	Arthrotomy with biopsy; metatarsophalangeal joint
28054	N/A	N/A	Arthrotomy with biopsy; interphalangeal joint
30100	N/A	N/A	Biopsy, intranasal
31050	N/A	N/A	Sinusotomy, sphenoid, with or without biopsy;
31051	N/A	N/A	Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)
31237	N/A	N/A	Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
31510	N/A	N/A	Laryngoscopy, indirect; with biopsy
31576	N/A	N/A	Laryngoscopy, flexible; with biopsy(ies)
31625	N/A	N/A	Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites
31628	N/A	N/A	Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe
31629	N/A	N/A	Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31717	N/A	N/A	Catheterization with bronchial brush biopsy
32100	N/A	N/A	Thoracotomy; with exploration
32400	N/A	N/A	Biopsy, pleura, percutaneous needle
32402	N/A	N/A	Biopsy, pleura; open
32405	N/A	N/A	Biopsy, lung or mediastinum, percutaneous needle
37200	N/A	N/A	Transcatheter biopsy
37609	N/A	N/A	Ligation or biopsy, temporal artery
38221	N/A	N/A	Diagnostic bone marrow; biopsy(ies)
38500	N/A	N/A	Biopsy or excision of lymph node(s); open, superficial
38505	N/A	N/A	Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)
38510	N/A	N/A	Biopsy or excision of lymph node(s); open, deep cervical node(s)
38520	N/A	N/A	Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
38525	N/A	N/A	Biopsy or excision of lymph node(s); open, deep axillary node(s)
38530	N/A	N/A	Biopsy or excision of lymph node(s); open, internal mammary node(s)
38570	N/A	N/A	Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple
38572	N/A	N/A	Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple
39400	N/A	N/A	Mediastinoscopy, includes biopsy(ies), when performed
40490	N/A	N/A	Biopsy of lip
40808	N/A	N/A	Biopsy, vestibule of mouth
41100	N/A	N/A	Biopsy of tongue; anterior two-thirds
41108	N/A	N/A	Biopsy of floor of mouth
42100	N/A	N/A	Biopsy of palate, uvula
42400	N/A	N/A	Biopsy of salivary gland; needle
42405	N/A	N/A	Biopsy of salivary gland; incisional
42800	N/A	N/A	Biopsy; oropharynx
42802	N/A	N/A	Biopsy; hypopharynx
42804	N/A	N/A	Biopsy; nasopharynx, visible lesion, simple
42806	N/A	N/A	Biopsy; nasopharynx, survey for unknown primary lesion
43202	N/A	N/A	Esophagoscopy, flexible, transoral; with biopsy, single or multiple
43239	N/A	N/A	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple
43261	N/A	N/A	Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple
43605	N/A	N/A	Biopsy of stomach, by laparotomy
44010	N/A	N/A	Duodenotomy, for exploration, biopsy(s), or foreign body removal
44020	N/A	N/A	Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal
44025	N/A	N/A	Colotomy, for exploration, biopsy(s), or foreign body removal
44100	N/A	N/A	Biopsy of intestine by capsule, tube, peroral (1 or more specimens)
44322	N/A	N/A	Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)
44361	N/A	N/A	Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple
44377	N/A	N/A	Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple
44382	N/A	N/A	Ileoscopy, through stoma; with biopsy, single or multiple
44389	N/A	N/A	Colonoscopy through stoma; with biopsy, single or multiple
45100	N/A	N/A	Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
45305	N/A	N/A	Proctosigmoidoscopy, rigid; with biopsy, single or multiple
45331	N/A	N/A	Sigmoidoscopy, flexible; with biopsy, single or multiple
45380	N/A	N/A	Colonoscopy, flexible; with biopsy, single or multiple
45392	N/A	N/A	Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures
46606	N/A	N/A	Anoscopy; with biopsy, single or multiple
47000	N/A	N/A	Biopsy of liver, needle; percutaneous
47001	N/A	N/A	Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure)
47100	N/A	N/A	Biopsy of liver, wedge
47553	N/A	N/A	Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple
47561	N/A	N/A	Laparoscopy, surgical; with guided transhepatic cholangiography with biopsy
48100	N/A	N/A	Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)
48102	N/A	N/A	Biopsy of pancreas, percutaneous needle
49000	N/A	N/A	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
49010	N/A	N/A	Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)
49180	N/A	N/A	Biopsy, abdominal or retroperitoneal mass, percutaneous needle
50200	N/A	N/A	Renal biopsy; percutaneous, by trocar or needle
50205	N/A	N/A	Renal biopsy; by surgical exposure of kidney
50555	N/A	N/A	Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50557	N/A	N/A	Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50574	N/A	N/A	Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50575	N/A	N/A	Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent)
50576	N/A	N/A	Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50955	N/A	N/A	Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50957	N/A	N/A	Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50974	N/A	N/A	Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50976	N/A	N/A	Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
52007	N/A	N/A	Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis
52204	N/A	N/A	Cystourethroscopy, with biopsy(s)
52224	N/A	N/A	Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy
52250	N/A	N/A	Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration
52354	N/A	N/A	Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
53200	N/A	N/A	Biopsy of urethra
54100	N/A	N/A	Biopsy of penis; (separate procedure)
54105	N/A	N/A	Biopsy of penis; deep structures
54500	N/A	N/A	Biopsy of testis, needle (separate procedure)
54501	N/A	N/A
54505	N/A	N/A	Biopsy of testis, incisional (separate procedure)
54800	N/A	N/A	Biopsy of epididymis, needle
54865	N/A	N/A	Exploration of epididymis, with or without biopsy
55700	N/A	N/A	Biopsy, prostate; needle or punch, single or multiple, any approach
55705	N/A	N/A	Biopsy, prostate; incisional, any approach
55706	N/A	N/A	Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance
56605	N/A	N/A	Biopsy of vulva or perineum (separate procedure); 1 lesion
56821	N/A	N/A	Colposcopy of the vulva; with biopsy(s)
57100	N/A	N/A	Biopsy of vaginal mucosa; simple (separate procedure)
57105	N/A	N/A	Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)
57421	N/A	N/A	Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix
57454	N/A	N/A	Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage
57455	N/A	N/A	Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix
57460	N/A	N/A	Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix
57500	N/A	N/A	Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)
57520	N/A	N/A	Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser
58100	N/A	N/A	Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)
58558	N/A	N/A	Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
58900	N/A	N/A	Biopsy of ovary, unilateral or bilateral (separate procedure)
59015	N/A	N/A	Chorionic villus sampling, any method
60540	N/A	N/A	Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);
60545	N/A	N/A	Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor
61140	N/A	N/A	Burr hole(s) or trephine; with biopsy of brain or intracranial lesion
61575	N/A	N/A	Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;
61576	N/A	N/A	Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)
61750	N/A	N/A	Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;
61751	N/A	N/A	Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance
62269	N/A	N/A	Biopsy of spinal cord, percutaneous needle
63275	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical
63276	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic
63277	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar
63278	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral
63279	N/A	N/A
63280	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical
63281	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic
63282	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar
63283	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral
63285	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical
63286	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic
63287	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar
63290	N/A	N/A	Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level
63615	N/A	N/A	Stereotactic biopsy, aspiration, or excision of lesion, spinal cord
64795	N/A	N/A	Biopsy of nerve
65410	N/A	N/A	Biopsy of cornea
67346	N/A	N/A	Biopsy of extraocular muscle
67400	N/A	N/A	Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy
67415	N/A	N/A	Fine needle aspiration of orbital contents
67450	N/A	N/A	Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy
67810	N/A	N/A	Incisional biopsy of eyelid skin including lid margin
68100	N/A	N/A	Biopsy of conjunctiva
68510	N/A	N/A	Biopsy of lacrimal gland
68525	N/A	N/A	Biopsy of lacrimal sac
69100	N/A	N/A	Biopsy external ear
69105	N/A	N/A	Biopsy external auditory canal
75970	N/A	N/A	Transcatheter biopsy, radiological supervision and interpretation
89290	N/A	N/A	Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos
89291	N/A	N/A	Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos
93505	N/A	N/A	Endomyocardial biopsy
HCPCS Codes
Code	Modifier	POS	Description
G8883	N/A	N/A	Biopsy results reviewed, communicated, tracked and documented
G8884	N/A	N/A	Clinician documented reason that patient's biopsy results were not reviewed
G8885	N/A	N/A	Biopsy results not reviewed, communicated, tracked or documented

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.

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