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

PQRS Measure

#321Participation by a Hospital, Physician or Other Clinician in a Systematic Clinical Database Registry that Includes Consensus Endorsed Quality
 Report via: Claim, Registry

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
90791N/AN/APsychiatric diagnostic evaluation
90792N/AN/APsychiatric diagnostic evaluation with medical services
90832N/AN/APsychotherapy, 30 minutes with patient
90834N/AN/APsychotherapy, 45 minutes with patient
90837N/AN/APsychotherapy, 60 minutes with patient
90839N/AN/APsychotherapy for crisis; first 60 minutes
92002N/AN/AOphthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004N/AN/AOphthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012N/AN/AOphthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014N/AN/AOphthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
92506N/AN/AEvaluation of speech, language, voice, communication, and/or auditory processing
92507N/AN/ATreatment of speech, language, voice, communication, and/or auditory processing disorder; individual
92508N/AN/ATreatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals
92526N/AN/ATreatment of swallowing dysfunction and/or oral function for feeding
92541N/AN/ASpontaneous nystagmus test, including gaze and fixation nystagmus, with recording
92542N/AN/APositional nystagmus test, minimum of 4 positions, with recording
92543N/AN/ACaloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests), with recording
92544N/AN/AOptokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
92548N/AN/AComputerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;
92552N/AN/APure tone audiometry (threshold); air only
92553N/AN/APure tone audiometry (threshold); air and bone
92555N/AN/ASpeech audiometry threshold;
92557N/AN/AComprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)
92561N/AN/ABekesy audiometry; diagnostic
92562N/AN/ALoudness balance test, alternate binaural or monaural
92563N/AN/ATone decay test
92564N/AN/AShort increment sensitivity index (SISI)
92565N/AN/AStenger test, pure tone
92567N/AN/ATympanometry (impedance testing)
92568N/AN/AAcoustic reflex testing, threshold
92570N/AN/AAcoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing
92571N/AN/AFiltered speech test
92572N/AN/AStaggered spondaic word test
92575N/AN/ASensorineural acuity level test
92576N/AN/ASynthetic sentence identification test
92577N/AN/AStenger test, speech
92579N/AN/AVisual reinforcement audiometry (VRA)
92582N/AN/AConditioning play audiometry
92584N/AN/AElectrocochleography
92585N/AN/AAuditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
92586N/AN/AAuditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited
92587N/AN/ADistortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
92588N/AN/ADistortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report
92601N/AN/ADiagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming
92602N/AN/ADiagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming
92603N/AN/ADiagnostic analysis of cochlear implant, age 7 years or older; with programming
92604N/AN/ADiagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming
92610N/AN/AEvaluation of oral and pharyngeal swallowing function
92611N/AN/AMotion fluoroscopic evaluation of swallowing function by cine or video recording
92612N/AN/AFlexible endoscopic evaluation of swallowing by cine or video recording;
92620N/AN/AEvaluation of central auditory function, with report; initial 60 minutes
92621N/AN/AEvaluation of central auditory function, with report; each additional 15 minutes (List separately in addition to code for primary procedure)
92625N/AN/AAssessment of tinnitus (includes pitch, loudness matching, and masking)
92626N/AN/AEvaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour
92627N/AN/AEvaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (List separately in addition to code for primary procedure)
92640N/AN/ADiagnostic analysis with programming of auditory brainstem implant, per hour
95920N/AN/AIntraoperative neurophysiology testing, per hour (List separately in addition to code for primary procedure)
96150N/AN/AHealth and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
96151N/AN/AHealth and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment
96152N/AN/AHealth and behavior intervention, each 15 minutes, face-to-face; individual
97001N/AN/APhysical therapy evaluation
97002N/AN/APhysical therapy re-evaluation
97003N/AN/AOccupational therapy evaluation
97004N/AN/AOccupational therapy re-evaluation
97532N/AN/ADevelopment of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
97750N/AN/APhysical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes
97802N/AN/AMedical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97803N/AN/AMedical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97804N/AN/AMedical nutrition therapy; group (2 or more individual(s)), each 30 minutes
98940N/AN/AChiropractic manipulative treatment (CMT); spinal, 1-2 regions
98941N/AN/AChiropractic manipulative treatment (CMT); spinal, 3-4 regions
98942N/AN/AChiropractic manipulative treatment (CMT); spinal, 5 regions
99201N/AN/AOffice or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202N/AN/AOffice or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
99203N/AN/AOffice or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
99204N/AN/AOffice or other outpatient visit for the evaluation and management of a new 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, 45 minutes must be met or exceeded.
99205N/AN/AOffice or other outpatient visit for the evaluation and management of a new 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, 60 minutes must be met or exceeded.
99212N/AN/AOffice or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.
99213N/AN/AOffice or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
99214N/AN/AOffice or other outpatient visit for the evaluation and management of an established 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, 30 minutes must be met or exceeded.
99215N/AN/AOffice or other outpatient visit for the evaluation and management of an established 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, 40 minutes must be met or exceeded.

HCPCS Codes

CodeModifierPOSDescription
D7140N/AN/A
D7210N/AN/A
G0101N/AN/ACervical or vaginal cancer screening; pelvic and clinical breast examination
G0108N/AN/ADiabetes outpatient self-management training services, individual, per 30 minutes
G0109N/AN/ADiabetes outpatient self-management training services, group session (2 or more), per 30 minutes
G0270N/AN/AMedical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
G0271N/AN/AMedical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
G0402N/AN/AInitial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0438N/AN/AAnnual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439N/AN/AAnnual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G0442N/AN/AAnnual alcohol misuse screening, 5 to 15 minutes
G0443N/AN/ABrief face-to-face behavioral counseling for alcohol misuse, 15 minutes
G0445N/AN/AHigh intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
G0446N/AN/AAnnual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
G0447N/AN/AFace-to-face behavioral counseling for obesity, 15 minutes
G0448N/AN/AInsertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing
G0449N/AN/AANNUAL FACE-TO-FACE OBESITY SCREENING, 15 MINUTES
G0450N/AN/ASCREENING FOR SEXUALLY TRANSMITTED INFECTIONS, INCLUDES LABORATORY TESTS FOR CHLAMYDIA, GONORRHEA, SYPHILIS AND HEPATITIS B
G8954N/AN/AComplete and appropriate patient data were reported to a qualified clinical database registry
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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