Each MIPS measure is reportable via the CMS-1500 claim form (or electronic equivalent) using Current Procedural Terminology (CPT) codes; International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes; and codes specific for each measure.
CPT Codes
- Indicate the procedure performed on the patient.
- Represent the measure’s denominator (the eligible patients for a measure) in conjunction with ICD-10-CM codes.
ICD-10-CM Codes
- Indicate the patient’s diagnosis.
- Represent the measure’s denominator (the eligible patients for a measure) in conjunction with CPT codes.
G-Codes and CPT Measure Codes
- Represents the measure’s numerator (action that the measure requires for reporting and performance).
- For Measures #130, #134, and #261, these are G-codes.
- For Measures #154 and #155 (both; one is a follow-up measure to the other), and for Measure #226, these are CPT codes with the possibility of modifiers.