AMA Clinical Examples in Radiology - 2016 Bulletin 1
CMS Clarifies Use of Physician Quality Reporting System Measures 145 and 405
CMS Clarifies Use of Physician Quality Reporting System Measures 145 and 405 Measure 145 : The Centers for Medicare and Medicaid Services' (CMS) guidance for the Physician Quality Reporting System (PQRS; measure 145) is to report G9500 or G9501 if the final report contains either radiation exposure indices or exposure time AND number of fluorographic images. Because the wording of the final measure cannot be revised at this time, CMS published an FAQ that states: For 2016 PQRS, the final report would need to include radiation exposure indices, or exposure time AND number of fluorographic images in order to...
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Article Overview
This article summarizes CMS clarification on selected Physician Quality Reporting System measures relevant to radiology reporting. It focuses on how the agency described measure applicability, the types of documentation referenced for performance, and the imaging contexts addressed in the 2016 guidance. The content is useful for coders, quality reporting staff, radiology practices, and compliance teams who need to understand whether the article applies to their reporting workflow and to review the associated CMS references.
Why This Topic Matters
Quality reporting guidance can affect how radiology documentation is interpreted for CMS reporting programs. Understanding the scope of these clarifications helps organizations review their reporting processes and compare them with the agency’s published guidance.
Article Sections
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Measure 145
CMS guidance for a Physician Quality Reporting System measure in radiology is discussed, along with the documentation concepts referenced by the agency for 2016 reporting. The section also notes a CMS clarification about what counts in the related image-count concept.
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Measure 405
CMS guidance for another quality measure is summarized, including the imaging modalities referenced in the 2016 clarification. The section points readers to the related CMS FAQ reference and help desk contact information.
What You Will Learn
- How CMS framed its 2016 clarification for selected Physician Quality Reporting System measures
- Which broad documentation concepts are tied to the radiology quality reporting discussion
- What imaging contexts are referenced in the measure-related clarification
- Where to look for the CMS FAQ references and support contact information
Who Should Read This
- Radiology coders
- Quality reporting staff
- Compliance teams
- Physician practices
- Revenue cycle professionals
Codes Discussed
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