PQRS Measure
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 99221 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | ||
| 99239 | Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter | ||
HCPCS Codes | |||
| Code | Modifier | POS | Description |
| G8696 | Antithrombotic therapy prescribed at discharge | ||
| G8696 | Antithrombotic therapy prescribed at discharge | ||
| G8697 | 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)) | ||
| G8698 | Antithrombotic therapy was not prescribed at discharge, reason not given | ||
| G8698 | Antithrombotic therapy was not prescribed at discharge, reason not given | ||
ICD9 Codes | |||
| Code | Modifier | POS | Description |
| 433.01 | Occlusion and stenosis of basilar artery with cerebral infarction | ||
| 433.11 | Occlusion and stenosis of carotid artery with cerebral infarction | ||
| 433.21 | Occlusion and stenosis of vertebral artery with cerebral infarction | ||
| 433.31 | Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction | ||
| 433.81 | Occlusion and stenosis of other specified precerebral artery with cerebral infarction | ||
| 433.91 | Occlusion and stenosis of unspecified precerebral artery with cerebral infarction | ||
| 434.01 | Cerebral thrombosis with cerebral infarction | ||
| 434.11 | Cerebral embolism with cerebral infarction | ||
| 434.91 | Cerebral artery occlusion, unspecified with cerebral infarction | ||
| 435.0 | Basilar artery syndrome | ||
| 435.1 | Vertebral artery syndrome | ||
| 435.2 | Subclavian steal syndrome | ||
| 435.3 | Vertebrobasilar artery syndrome | ||
| 435.8 | Other specified transient cerebral ischemias | ||
| 435.9 | Unspecified transient cerebral ischemia | ||
ICD10CM Codes | |||
| Code | Modifier | POS | Description |
| G45.0 | Vertebro-basilar artery syndrome | ||
| G45.1 | Carotid artery syndrome (hemispheric) | ||
| G45.2 | Multiple and bilateral precerebral artery syndromes | ||
| G45.8 | Other transient cerebral ischemic attacks and related syndromes | ||
| G45.9 | Transient cerebral ischemic attack, unspecified | ||
| G46.0 | Middle cerebral artery syndrome | ||
| G46.1 | Anterior cerebral artery syndrome | ||
| G46.2 | Posterior cerebral artery syndrome | ||
| I63.00 | Cerebral infarction due to thrombosis of unspecified precerebral artery | ||
| I63.011 | Cerebral infarction due to thrombosis of right vertebral artery | ||
| I63.012 | Cerebral infarction due to thrombosis of left vertebral artery | ||
| I63.019 | Cerebral infarction due to thrombosis of unspecified vertebral artery | ||
| I63.02 | Cerebral infarction due to thrombosis of basilar artery | ||
| I63.031 | Cerebral infarction due to thrombosis of right carotid artery | ||
| I63.032 | Cerebral infarction due to thrombosis of left carotid artery | ||
| I63.039 | Cerebral infarction due to thrombosis of unspecified carotid artery | ||
| I63.09 | Cerebral infarction due to thrombosis of other precerebral artery | ||
| I63.10 | Cerebral infarction due to embolism of unspecified precerebral artery | ||
| I63.111 | Cerebral infarction due to embolism of right vertebral artery | ||
| I63.112 | Cerebral infarction due to embolism of left vertebral artery | ||
| I63.119 | Cerebral infarction due to embolism of unspecified vertebral artery | ||
| I63.12 | Cerebral infarction due to embolism of basilar artery | ||
| I63.131 | Cerebral infarction due to embolism of right carotid artery | ||
| I63.132 | Cerebral infarction due to embolism of left carotid artery | ||
| I63.139 | Cerebral infarction due to embolism of unspecified carotid artery | ||
| I63.19 | Cerebral infarction due to embolism of other precerebral artery | ||
| I63.20 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries | ||
| I63.211 | Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery | ||
| I63.212 | Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery | ||
| I63.219 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery | ||
| I63.22 | Cerebral infarction due to unspecified occlusion or stenosis of basilar artery | ||
| I63.231 | Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries | ||
| I63.232 | Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries | ||
| I63.239 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery | ||
| I63.29 | Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries | ||
| I63.30 | Cerebral infarction due to thrombosis of unspecified cerebral artery | ||
| I63.311 | Cerebral infarction due to thrombosis of right middle cerebral artery | ||
| I63.312 | Cerebral infarction due to thrombosis of left middle cerebral artery | ||
| I63.319 | Cerebral infarction due to thrombosis of unspecified middle cerebral artery | ||
| I63.321 | Cerebral infarction due to thrombosis of right anterior cerebral artery | ||
| I63.322 | Cerebral infarction due to thrombosis of left anterior cerebral artery | ||
| I63.329 | Cerebral infarction due to thrombosis of unspecified anterior cerebral artery | ||
| I63.331 | Cerebral infarction due to thrombosis of right posterior cerebral artery | ||
| I63.332 | Cerebral infarction due to thrombosis of left posterior cerebral artery | ||
| I63.339 | Cerebral infarction due to thrombosis of unspecified posterior cerebral artery | ||
| I63.341 | Cerebral infarction due to thrombosis of right cerebellar artery | ||
| I63.342 | Cerebral infarction due to thrombosis of left cerebellar artery | ||
| I63.349 | Cerebral infarction due to thrombosis of unspecified cerebellar artery | ||
| I63.39 | Cerebral infarction due to thrombosis of other cerebral artery | ||
| I63.40 | Cerebral infarction due to embolism of unspecified cerebral artery | ||
| I63.411 | Cerebral infarction due to embolism of right middle cerebral artery | ||
| I63.412 | Cerebral infarction due to embolism of left middle cerebral artery | ||
| I63.419 | Cerebral infarction due to embolism of unspecified middle cerebral artery | ||
| I63.421 | Cerebral infarction due to embolism of right anterior cerebral artery | ||
| I63.422 | Cerebral infarction due to embolism of left anterior cerebral artery | ||
| I63.429 | Cerebral infarction due to embolism of unspecified anterior cerebral artery | ||
| I63.431 | Cerebral infarction due to embolism of right posterior cerebral artery | ||
| I63.432 | Cerebral infarction due to embolism of left posterior cerebral artery | ||
| I63.439 | Cerebral infarction due to embolism of unspecified posterior cerebral artery | ||
| I63.441 | Cerebral infarction due to embolism of right cerebellar artery | ||
| I63.442 | Cerebral infarction due to embolism of left cerebellar artery | ||
| I63.449 | Cerebral infarction due to embolism of unspecified cerebellar artery | ||
| I63.49 | Cerebral infarction due to embolism of other cerebral artery | ||
| I63.50 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery | ||
| I63.511 | Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery | ||
| I63.512 | Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery | ||
| I63.519 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery | ||
| I63.521 | Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery | ||
| I63.531 | Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery | ||
| I63.532 | Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery | ||
| I63.539 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery | ||
| I63.541 | Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery | ||
| I63.542 | Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery | ||
| I63.549 | Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery | ||
| I63.59 | Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery | ||
| I63.6 | Cerebral infarction due to cerebral venous thrombosis, nonpyogenic | ||
| I63.8 | Other cerebral infarction | ||
| I63.9 | 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).
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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