PQRS Information

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

PQRS Measure

#31Stroke and Stroke Rehabilitation: Venous Thromboembolism (VTE) Prophylaxis for Ischemic Stroke or Intracranial Hemorrhage

Report via: Claim, Registry

The following codes apply for this PQRS measure:

Code	Modifier	POS	Description
CPT Codes
99221	N/A	N/A	Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
99222	N/A	N/A	Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.
99223	N/A	N/A	Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.
99231	N/A	N/A	Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded.
99232	N/A	N/A	Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.
99233	N/A	N/A	Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.
99291	N/A	N/A	Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
HCPCS Codes
Code	Modifier	POS	Description
G9201	N/A	N/A	Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
G9201	N/A	N/A	Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission
G9199	N/A	N/A	Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))
G9200	N/A	N/A	Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
G9200	N/A	N/A	Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given
ICD9 Codes
Code	Modifier	POS	Description
430	N/A	N/A	Subarachnoid hemorrhage
431	N/A	N/A	Intracerebral hemorrhage
432.0	N/A	N/A	Nontraumatic extradural hemorrhage
432.1	N/A	N/A	Subdural hemorrhage
432.9	N/A	N/A	Unspecified intracranial hemorrhage
433.01	N/A	N/A	Occlusion and stenosis of basilar artery with cerebral infarction
433.11	N/A	N/A	Occlusion and stenosis of carotid artery with cerebral infarction
433.21	N/A	N/A	Occlusion and stenosis of vertebral artery with cerebral infarction
433.31	N/A	N/A	Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction
433.81	N/A	N/A	Occlusion and stenosis of other specified precerebral artery with cerebral infarction
433.91	N/A	N/A	Occlusion and stenosis of unspecified precerebral artery with cerebral infarction
434.01	N/A	N/A	Cerebral thrombosis with cerebral infarction
434.11	N/A	N/A	Cerebral embolism with cerebral infarction
434.91	N/A	N/A	Cerebral artery occlusion, unspecified with cerebral infarction
ICD10CM Codes
Code	Modifier	POS	Description
I60.00	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation
I60.01	N/A	N/A	Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation
I60.02	N/A	N/A	Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation
I60.10	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery
I60.11	N/A	N/A	Nontraumatic subarachnoid hemorrhage from right middle cerebral artery
I60.12	N/A	N/A	Nontraumatic subarachnoid hemorrhage from left middle cerebral artery
I60.20	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating artery
I60.21	N/A	N/A	Nontraumatic subarachnoid hemorrhage from right anterior communicating artery
I60.22	N/A	N/A	Nontraumatic subarachnoid hemorrhage from left anterior communicating artery
I60.30	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery
I60.31	N/A	N/A	Nontraumatic subarachnoid hemorrhage from right posterior communicating artery
I60.32	N/A	N/A	Nontraumatic subarachnoid hemorrhage from left posterior communicating artery
I60.4	N/A	N/A	Nontraumatic subarachnoid hemorrhage from basilar artery
I60.50	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery
I60.51	N/A	N/A	Nontraumatic subarachnoid hemorrhage from right vertebral artery
I60.52	N/A	N/A	Nontraumatic subarachnoid hemorrhage from left vertebral artery
I60.6	N/A	N/A	Nontraumatic subarachnoid hemorrhage from other intracranial arteries
I60.7	N/A	N/A	Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery
I60.8	N/A	N/A	Other nontraumatic subarachnoid hemorrhage
I60.9	N/A	N/A	Nontraumatic subarachnoid hemorrhage, unspecified
I61.0	N/A	N/A	Nontraumatic intracerebral hemorrhage in hemisphere, subcortical
I61.1	N/A	N/A	Nontraumatic intracerebral hemorrhage in hemisphere, cortical
I61.2	N/A	N/A	Nontraumatic intracerebral hemorrhage in hemisphere, unspecified
I61.3	N/A	N/A	Nontraumatic intracerebral hemorrhage in brain stem
I61.4	N/A	N/A	Nontraumatic intracerebral hemorrhage in cerebellum
I61.5	N/A	N/A	Nontraumatic intracerebral hemorrhage, intraventricular
I61.6	N/A	N/A	Nontraumatic intracerebral hemorrhage, multiple localized
I61.8	N/A	N/A	Other nontraumatic intracerebral hemorrhage
I61.9	N/A	N/A	Nontraumatic intracerebral hemorrhage, unspecified
I62.00	N/A	N/A	Nontraumatic subdural hemorrhage, unspecified
I62.01	N/A	N/A	Nontraumatic acute subdural hemorrhage
I62.02	N/A	N/A	Nontraumatic subacute subdural hemorrhage
I62.03	N/A	N/A	Nontraumatic chronic subdural hemorrhage
I62.1	N/A	N/A	Nontraumatic extradural hemorrhage
I62.9	N/A	N/A	Nontraumatic intracranial hemorrhage, unspecified
I63.00	N/A	N/A	Cerebral infarction due to thrombosis of unspecified precerebral artery
I63.011	N/A	N/A	Cerebral infarction due to thrombosis of right vertebral artery
I63.012	N/A	N/A	Cerebral infarction due to thrombosis of left vertebral artery
I63.019	N/A	N/A	Cerebral infarction due to thrombosis of unspecified vertebral artery
I63.02	N/A	N/A	Cerebral infarction due to thrombosis of basilar artery
I63.031	N/A	N/A	Cerebral infarction due to thrombosis of right carotid artery
I63.032	N/A	N/A	Cerebral infarction due to thrombosis of left carotid artery
I63.039	N/A	N/A	Cerebral infarction due to thrombosis of unspecified carotid artery
I63.09	N/A	N/A	Cerebral infarction due to thrombosis of other precerebral artery
I63.10	N/A	N/A	Cerebral infarction due to embolism of unspecified precerebral artery
I63.111	N/A	N/A	Cerebral infarction due to embolism of right vertebral artery
I63.112	N/A	N/A	Cerebral infarction due to embolism of left vertebral artery
I63.119	N/A	N/A	Cerebral infarction due to embolism of unspecified vertebral artery
I63.12	N/A	N/A	Cerebral infarction due to embolism of basilar artery
I63.131	N/A	N/A	Cerebral infarction due to embolism of right carotid artery
I63.132	N/A	N/A	Cerebral infarction due to embolism of left carotid artery
I63.139	N/A	N/A	Cerebral infarction due to embolism of unspecified carotid artery
I63.19	N/A	N/A	Cerebral infarction due to embolism of other precerebral artery
I63.20	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
I63.211	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery
I63.212	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery
I63.219	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
I63.22	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of basilar artery
I63.231	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.239	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
I63.29	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries
I63.30	N/A	N/A	Cerebral infarction due to thrombosis of unspecified cerebral artery
I63.311	N/A	N/A	Cerebral infarction due to thrombosis of right middle cerebral artery
I63.312	N/A	N/A	Cerebral infarction due to thrombosis of left middle cerebral artery
I63.319	N/A	N/A	Cerebral infarction due to thrombosis of unspecified middle cerebral artery
I63.321	N/A	N/A	Cerebral infarction due to thrombosis of right anterior cerebral artery
I63.322	N/A	N/A	Cerebral infarction due to thrombosis of left anterior cerebral artery
I63.329	N/A	N/A	Cerebral infarction due to thrombosis of unspecified anterior cerebral artery
I63.331	N/A	N/A	Cerebral infarction due to thrombosis of right posterior cerebral artery
I63.332	N/A	N/A	Cerebral infarction due to thrombosis of left posterior cerebral artery
I63.339	N/A	N/A	Cerebral infarction due to thrombosis of unspecified posterior cerebral artery
I63.341	N/A	N/A	Cerebral infarction due to thrombosis of right cerebellar artery
I63.342	N/A	N/A	Cerebral infarction due to thrombosis of left cerebellar artery
I63.349	N/A	N/A	Cerebral infarction due to thrombosis of unspecified cerebellar artery
I63.39	N/A	N/A	Cerebral infarction due to thrombosis of other cerebral artery
I63.40	N/A	N/A	Cerebral infarction due to embolism of unspecified cerebral artery
I63.411	N/A	N/A	Cerebral infarction due to embolism of right middle cerebral artery
I63.412	N/A	N/A	Cerebral infarction due to embolism of left middle cerebral artery
I63.419	N/A	N/A	Cerebral infarction due to embolism of unspecified middle cerebral artery
I63.421	N/A	N/A	Cerebral infarction due to embolism of right anterior cerebral artery
I63.422	N/A	N/A	Cerebral infarction due to embolism of left anterior cerebral artery
I63.429	N/A	N/A	Cerebral infarction due to embolism of unspecified anterior cerebral artery
I63.431	N/A	N/A	Cerebral infarction due to embolism of right posterior cerebral artery
I63.432	N/A	N/A	Cerebral infarction due to embolism of left posterior cerebral artery
I63.439	N/A	N/A	Cerebral infarction due to embolism of unspecified posterior cerebral artery
I63.441	N/A	N/A	Cerebral infarction due to embolism of right cerebellar artery
I63.442	N/A	N/A	Cerebral infarction due to embolism of left cerebellar artery
I63.449	N/A	N/A	Cerebral infarction due to embolism of unspecified cerebellar artery
I63.49	N/A	N/A	Cerebral infarction due to embolism of other cerebral artery
I63.50	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.511	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery
I63.512	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery
I63.519	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery
I63.521	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery
I63.522	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery
I63.529	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery
I63.531	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
I63.532	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery
I63.539	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery
I63.541	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery
I63.542	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery
I63.549	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery
I63.59	N/A	N/A	Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I63.6	N/A	N/A	Cerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.8	N/A	N/A	Other cerebral infarction
I63.9	N/A	N/A	Cerebral infarction, unspecified

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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