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PQRS Measure

 This measure may be submitted via Registry only

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
99221N/AN/AInitial 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.
99222N/AN/AInitial 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.
99223N/AN/AInitial 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.
99231N/AN/ASubsequent 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.
99232N/AN/ASubsequent 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.
99233N/AN/ASubsequent 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.
99238N/AN/AHospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter
99239N/AN/AHospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter
4075FN/AN/AAnticoagulant therapy prescribed at discharge (STR)
4075F1PN/AAnticoagulant therapy prescribed at discharge (STR)
4075F2PN/AAnticoagulant therapy prescribed at discharge (STR)
4075F8PN/AAnticoagulant therapy prescribed at discharge (STR)

ICD9 Codes

CodeModifierPOSDescription
427.31N/AN/AAtrial fibrillation
433.01N/AN/AOcclusion and stenosis of basilar artery with cerebral infarction
433.11N/AN/AOcclusion and stenosis of carotid artery with cerebral infarction
433.21N/AN/AOcclusion and stenosis of vertebral artery with cerebral infarction
433.31N/AN/AOcclusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction
433.81N/AN/AOcclusion and stenosis of other specified precerebral artery with cerebral infarction
433.91N/AN/AOcclusion and stenosis of unspecified precerebral artery with cerebral infarction
434.01N/AN/ACerebral thrombosis with cerebral infarction
434.11N/AN/ACerebral embolism with cerebral infarction
434.91N/AN/ACerebral artery occlusion, unspecified with cerebral infarction
435.0N/AN/ABasilar artery syndrome
435.1N/AN/AVertebral artery syndrome
435.2N/AN/ASubclavian steal syndrome
435.3N/AN/AVertebrobasilar artery syndrome
435.8N/AN/AOther specified transient cerebral ischemias
435.9N/AN/AUnspecified transient cerebral ischemia

ICD10CM Codes

CodeModifierPOSDescription
G45.0N/AN/AVertebro-basilar artery syndrome
G45.1N/AN/ACarotid artery syndrome (hemispheric)
G45.2N/AN/AMultiple and bilateral precerebral artery syndromes
G45.8N/AN/AOther transient cerebral ischemic attacks and related syndromes
G45.9N/AN/ATransient cerebral ischemic attack, unspecified
G46.0N/AN/AMiddle cerebral artery syndrome
G46.1N/AN/AAnterior cerebral artery syndrome
G46.2N/AN/APosterior cerebral artery syndrome
I48.0N/AN/AParoxysmal atrial fibrillation
I48.1N/AN/APersistent atrial fibrillation
I48.2N/AN/AChronic atrial fibrillation
I63.00N/AN/ACerebral infarction due to thrombosis of unspecified precerebral artery
I63.011N/AN/ACerebral infarction due to thrombosis of right vertebral artery
I63.012N/AN/ACerebral infarction due to thrombosis of left vertebral artery
I63.019N/AN/ACerebral infarction due to thrombosis of unspecified vertebral artery
I63.02N/AN/ACerebral infarction due to thrombosis of basilar artery
I63.031N/AN/ACerebral infarction due to thrombosis of right carotid artery
I63.032N/AN/ACerebral infarction due to thrombosis of left carotid artery
I63.039N/AN/ACerebral infarction due to thrombosis of unspecified carotid artery
I63.09N/AN/ACerebral infarction due to thrombosis of other precerebral artery
I63.10N/AN/ACerebral infarction due to embolism of unspecified precerebral artery
I63.111N/AN/ACerebral infarction due to embolism of right vertebral artery
I63.112N/AN/ACerebral infarction due to embolism of left vertebral artery
I63.119N/AN/ACerebral infarction due to embolism of unspecified vertebral artery
I63.12N/AN/ACerebral infarction due to embolism of basilar artery
I63.131N/AN/ACerebral infarction due to embolism of right carotid artery
I63.132N/AN/ACerebral infarction due to embolism of left carotid artery
I63.139N/AN/ACerebral infarction due to embolism of unspecified carotid artery
I63.19N/AN/ACerebral infarction due to embolism of other precerebral artery
I63.20N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
I63.211N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right vertebral artery
I63.212N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left vertebral artery
I63.219N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
I63.22N/AN/ACerebral infarction due to unspecified occlusion or stenosis of basilar artery
I63.231N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.239N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
I63.29N/AN/ACerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries
I63.30N/AN/ACerebral infarction due to thrombosis of unspecified cerebral artery
I63.311N/AN/ACerebral infarction due to thrombosis of right middle cerebral artery
I63.312N/AN/ACerebral infarction due to thrombosis of left middle cerebral artery
I63.319N/AN/ACerebral infarction due to thrombosis of unspecified middle cerebral artery
I63.321N/AN/ACerebral infarction due to thrombosis of right anterior cerebral artery
I63.322N/AN/ACerebral infarction due to thrombosis of left anterior cerebral artery
I63.329N/AN/ACerebral infarction due to thrombosis of unspecified anterior cerebral artery
I63.331N/AN/ACerebral infarction due to thrombosis of right posterior cerebral artery
I63.332N/AN/ACerebral infarction due to thrombosis of left posterior cerebral artery
I63.339N/AN/ACerebral infarction due to thrombosis of unspecified posterior cerebral artery
I63.341N/AN/ACerebral infarction due to thrombosis of right cerebellar artery
I63.342N/AN/ACerebral infarction due to thrombosis of left cerebellar artery
I63.349N/AN/ACerebral infarction due to thrombosis of unspecified cerebellar artery
I63.39N/AN/ACerebral infarction due to thrombosis of other cerebral artery
I63.40N/AN/ACerebral infarction due to embolism of unspecified cerebral artery
I63.411N/AN/ACerebral infarction due to embolism of right middle cerebral artery
I63.412N/AN/ACerebral infarction due to embolism of left middle cerebral artery
I63.419N/AN/ACerebral infarction due to embolism of unspecified middle cerebral artery
I63.421N/AN/ACerebral infarction due to embolism of right anterior cerebral artery
I63.422N/AN/ACerebral infarction due to embolism of left anterior cerebral artery
I63.429N/AN/ACerebral infarction due to embolism of unspecified anterior cerebral artery
I63.431N/AN/ACerebral infarction due to embolism of right posterior cerebral artery
I63.432N/AN/ACerebral infarction due to embolism of left posterior cerebral artery
I63.439N/AN/ACerebral infarction due to embolism of unspecified posterior cerebral artery
I63.441N/AN/ACerebral infarction due to embolism of right cerebellar artery
I63.442N/AN/ACerebral infarction due to embolism of left cerebellar artery
I63.449N/AN/ACerebral infarction due to embolism of unspecified cerebellar artery
I63.49N/AN/ACerebral infarction due to embolism of other cerebral artery
I63.50N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.511N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery
I63.512N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery
I63.519N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery
I63.521N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery
I63.522N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery
I63.529N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery
I63.531N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
I63.532N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery
I63.539N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery
I63.541N/AN/ACerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery
I63.542N/AN/ACerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery
I63.549N/AN/ACerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery
I63.59N/AN/ACerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I63.6N/AN/ACerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.8N/AN/AOther cerebral infarction
I63.9N/AN/ACerebral 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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