Each PQRS 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.
- Indicate the procedure performed on the patient
- Represent the measures’ denominator (the eligible patients for a measure) in conjunction with ICD-10-CM codes
- Indicate the diagnosis of the patient
- Represent the measures’ denominator (the eligible patients for a measure) in conjunction with CPT codes
G Code and CPT II Measure Codes
- Represents the measures’ numerator (action required by the measure for reporting and performance).
- For measures #261, #130, and #134, these are G codes
- For measures #154 (both), and #226, these are CPT II codes with the possibility of modifiers