PQRS Measure
#36Stroke and Stroke Rehabilitation: Rehabilitation Services Ordered
Report via: Claim, Registry
The following codes apply for this PQRS measure:
CPT Codes | |||
| Code | Modifier | POS | Description |
|---|---|---|---|
| 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 |
| G8699 | N/A | N/A | Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge |
| G8700 | N/A | N/A | Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge |
| G8701 | N/A | N/A | Rehabilitation services were not ordered, reason not otherwise specified |
| G8699 | N/A | N/A | Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge |
| G8701 | N/A | N/A | Rehabilitation services were not ordered, reason not otherwise specified |
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 |
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 IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.
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).
GPRO IThis measure can be submitted via Group Practice Reporting Option 1.
GPRO IIThis measure can be submitted via Group Practice Reporting Option 2.
More information on these alternative reporting mechanisms is available at:
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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