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PQRS Measure

 Report via: Claim, Registry, EHR, Measure Group
 This measure is can be reported as part of the following groups:
 Asthma Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
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.
99341N/AN/AHome or residence 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.
99342N/AN/AHome or residence 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.
99343N/AN/AHome visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. 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 of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344N/AN/AHome or residence 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, 60 minutes must be met or exceeded.
99345N/AN/AHome or residence 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, 75 minutes must be met or exceeded.
99347N/AN/AHome or residence 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, 20 minutes must be met or exceeded.
99348N/AN/AHome or residence 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, 30 minutes must be met or exceeded.
99349N/AN/AHome or residence 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, 40 minutes must be met or exceeded.
99350N/AN/AHome or residence 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, 60 minutes must be met or exceeded.
1038FN/AN/APersistent asthma (mild, moderate or severe) (Asthma)
1039FN/AN/AIntermittent asthma (Asthma)
4140FN/AN/AInhaled corticosteroids prescribed (Asthma)
4140F2PN/AInhaled corticosteroids prescribed (Asthma)
4140F8PN/AInhaled corticosteroids prescribed (Asthma)
4144FN/AN/AAlternative long-term control medication prescribed (Asthma)

ICD9 Codes

CodeModifierPOSDescription
493.00N/AN/AExtrinsic asthma, unspecified
493.01N/AN/AExtrinsic asthma with status asthmaticus
493.02N/AN/AExtrinsic asthma with (acute) exacerbation
493.10N/AN/AIntrinsic asthma, unspecified
493.11N/AN/AIntrinsic asthma with status asthmaticus
493.12N/AN/AIntrinsic asthma with (acute) exacerbation
493.20N/AN/AChronic obstructive asthma, unspecified
493.21N/AN/AChronic obstructive asthma with status asthmaticus
493.22N/AN/AChronic obstructive asthma with (acute) exacerbation
493.81N/AN/AExercise induced bronchospasm
493.82N/AN/ACough variant asthma
493.90N/AN/AAsthma, unspecified type, unspecified
493.91N/AN/AAsthma, unspecified type, with status asthmaticus
493.92N/AN/AAsthma, unspecified type, with (acute) exacerbation

ICD10CM Codes

CodeModifierPOSDescription
J45.20N/AN/AMild intermittent asthma, uncomplicated
J45.21N/AN/AMild intermittent asthma with (acute) exacerbation
J45.22N/AN/AMild intermittent asthma with status asthmaticus
J45.30N/AN/AMild persistent asthma, uncomplicated
J45.31N/AN/AMild persistent asthma with (acute) exacerbation
J45.32N/AN/AMild persistent asthma with status asthmaticus
J45.40N/AN/AModerate persistent asthma, uncomplicated
J45.41N/AN/AModerate persistent asthma with (acute) exacerbation
J45.42N/AN/AModerate persistent asthma with status asthmaticus
J45.50N/AN/ASevere persistent asthma, uncomplicated
J45.51N/AN/ASevere persistent asthma with (acute) exacerbation
J45.901N/AN/AUnspecified asthma with (acute) exacerbation
J45.902N/AN/AUnspecified asthma with status asthmaticus
J45.909N/AN/AUnspecified asthma, uncomplicated
J45.990N/AN/AExercise induced bronchospasm
J45.991N/AN/ACough variant asthma
J45.998N/AN/AOther asthma
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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