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PQRS Measure

#36Stroke and Stroke Rehabilitation: Rehabilitation Services Ordered
 Report via: Claim, Registry

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.
99234N/AN/AHospital 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.
99235N/AN/AHospital 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.
99236N/AN/AHospital 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.
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

HCPCS Codes

CodeModifierPOSDescription
G8699N/AN/ARehabilitation services (occupational, physical or speech) ordered at or prior to discharge
G8700N/AN/ARehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
G8701N/AN/ARehabilitation services were not ordered, reason not otherwise specified
G8699N/AN/ARehabilitation services (occupational, physical or speech) ordered at or prior to discharge
G8701N/AN/ARehabilitation services were not ordered, reason not otherwise specified

ICD9 Codes

CodeModifierPOSDescription
430N/AN/ASubarachnoid hemorrhage
431N/AN/AIntracerebral hemorrhage
432.0N/AN/ANontraumatic extradural hemorrhage
432.1N/AN/ASubdural hemorrhage
432.9N/AN/AUnspecified intracranial hemorrhage
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
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.
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