PQRS Information

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

PQRS Measure

#32Stroke and Stroke Rehabilitation: Discharged on Anithrombotic Therapy

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.
99234	N/A	N/A	Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, 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, 45 minutes must be met or exceeded.
99235	N/A	N/A	Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, 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, 70 minutes must be met or exceeded.
99236	N/A	N/A	Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, 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, 85 minutes must be met or exceeded.
99238	N/A	N/A	Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter
99239	N/A	N/A	Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter
HCPCS Codes
Code	Modifier	POS	Description
G8696	N/A	N/A	Antithrombotic therapy prescribed at discharge
G8698	N/A	N/A	Antithrombotic therapy was not prescribed at discharge, reason not given
G8697	N/A	N/A	Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))
ICD9 Codes
Code	Modifier	POS	Description
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
435.0	N/A	N/A	Basilar artery syndrome
435.1	N/A	N/A	Vertebral artery syndrome
435.2	N/A	N/A	Subclavian steal syndrome
435.3	N/A	N/A	Vertebrobasilar artery syndrome
435.8	N/A	N/A	Other specified transient cerebral ischemias
435.9	N/A	N/A	Unspecified transient cerebral ischemia
ICD10CM Codes
Code	Modifier	POS	Description
G45.0	N/A	N/A	Vertebro-basilar artery syndrome
G45.1	N/A	N/A	Carotid artery syndrome (hemispheric)
G45.2	N/A	N/A	Multiple and bilateral precerebral artery syndromes
G45.8	N/A	N/A	Other transient cerebral ischemic attacks and related syndromes
G45.9	N/A	N/A	Transient cerebral ischemic attack, unspecified
G46.0	N/A	N/A	Middle cerebral artery syndrome
G46.1	N/A	N/A	Anterior cerebral artery syndrome
G46.2	N/A	N/A	Posterior cerebral artery syndrome
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
I63.531	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.

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

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PQRS Measure

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