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March 27, 2018

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Medical Coding News Archives

HCPCS Changes to PQRI Codes

December 9, 2008:

It comes as no surprise that the annual HCPCS code update affects many of the codes relevant to the method of reporting data for the Physician Quality Reporting Initiative (PQRI), which includes groups of clinically related measures rather than individual measures.

A provision of the Medicare, Medicaid, and SCHIP Extension Act granted CMS the authority to develop the alternative method, which includes the following four measure groups established for 2008 PQRI: diabetes mellitus, end-stage renal disease (ESRD), chronic kidney disease (CKD), and preventive care.

Keep in mind that HCPCS codes are updated quarterly although the annual update isn’t released until late fall. The complete version of this annual update can be found on the HCPCS website at: http://www.cms.hhs.gov/HCPCSReleaseCodeSets/ANHCPCS/list.asp.

The new G codes include:

G8485-G8493 G8544 Statement of intention to report a specific measures group
G8494-G8502 Statement that applicable actions for a specific measures group performed.
G8503-G8507 Statement that specific medications were administered
G8508-G8509 Pain assessment documented
G8510-G8511 Documentation of screen for clinical depression
G8512 Pain severity quantified; pain present
G8513-G8515 Documentation of ABI measurement
G8516-G8517 Screening for risk of future falls
G8518-G8520 Preoperative documentation of clinical stage lung and esophageal cancer
G8521-G8523 Documentation of anti-platelet therapy
G8524-G8526 Documentation of patch closure for patient undergoing CEA
G8527-G8529 Documentation of order for prophylactic cefazolin or cefuroxime
G8530-G8532 Documentation of autogenous AV fistula
G8533 Participation by physician/clinician in systematic quality measure database
G8534-G8538 Documentation of an elder maltreatment screen
G8539-G8543 Documentation of a current functional outcome assessment

Revised G codes include:

G8417-G8420 Calculated BMI
G8427-G8430 Documentation of current medications
G8431-G8433 Clinical depression screening  
G8437-G8439 Documentation care plan development
G8440 Documentation of pain assessment
G8446 Provider does have access to a qualified e-prescribing system
G8447-G8448 Patient encounters documentation using an EHR
G8457 Current tobacco nonuser
G8485 Statement of intention to report the diabetes mellitus measures group
G8486 Statement of intention to report the preventive care measures group
G8487 Statement of intention to report the chronic kidney disease (CKD) measures group

Karen H. Kachur, RN, CPC
Clinical/Technical Editor


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