decisionhealth Newsletters, Part B News - 2016 Issue 12 (December)
CMS institutes ICD-10-CM flexibilities for the final quarter of PQRS
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Article Overview
This article covers CMS communication about quality reporting flexibility linked to ICD-10-CM code-set changes in the fourth quarter of 2016. It is relevant to physician practices, group practices, ACO participants, and coding or quality-reporting staff who monitor PQRS performance, denominator-based measures, and potential payment adjustments. The discussion focuses on the circumstances CMS said may affect processing, the types of providers and reporting situations involved, and the need to review reports and seek follow-up if needed.
Why This Topic Matters
It helps practices understand whether ICD-10-CM transition issues may have affected 2016 quality reporting and whether CMS flexibility could influence PQRS payment adjustments or related review steps.
Article Sections
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CMS announcement and reporting flexibility
Summarizes CMS communication about temporary flexibility related to quality reporting during the final quarter of 2016 and the populations potentially affected.
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Impact of ICD-10-CM updates on quality measures
Explains the general reporting challenges tied to diagnosis-code updates and why certain quality measures may have been affected.
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ACO and review follow-up considerations
Describes the reporting situations involving ACO participants and the general recommendation to review reporting results and seek follow-up if needed.
What You Will Learn
- How CMS described its temporary flexibility for certain quality reporting situations
- Which provider groups and reporting contexts were discussed
- Why ICD-10-CM updates could affect quality data processing
- What general follow-up steps practices were advised to consider
Who Should Read This
- Physician practices
- Group practices
- Quality reporting staff
- Medical coders
- Compliance staff
- ACO participants
Codes Discussed
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