decisionhealth Newsletters, Part B News - 2009 Issue 12 (December)
Download PQRI information today, avoid code reporting errors in 2010
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Article Overview
This piece is for providers and coders who report Physician Quality Reporting Initiative (PQRI) measures and need to verify 2010 specification changes. It highlights why prior reporting experience is not enough, points to CMS resources for updated measure manuals and release notes, and notes that several measures had changes to eligible encounters and reporting options.
Why This Topic Matters
PQRI reporting depends on current measure specifications, and changes between reporting years can affect whether claims are reportable. Reviewing the updated CMS materials helps practices avoid reporting errors when submitting quality data for 2010.
Article Sections
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PQRI measure updates for 2010
Overview of why prior year reporting patterns may not carry forward and why the 2010 CMS materials should be reviewed. Introduces the general types of measure changes that can affect reporting.
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Using the 2010 CMS measure specifications and release notes
Describes the CMS resources available for reviewing eligible patients, encounters, quality data codes, modifiers, and other measure information. Notes the use of release notes to compare changes across reporting years.
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Examples of measure changes
Summarizes examples of updated measure content affecting eligible encounters for selected PQRI measures. Shows that both additions and deletions can occur across reporting periods.
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Consultation code changes affecting PQRI reporting
Explains that some measures are affected by the removal of consultation billing and the resulting shift to other encounter types. Refers to stroke-related measures as an example of the broader impact.
What You Will Learn
- How PQRI measure specifications can change from one reporting period to the next.
- Where to find CMS materials for reviewing updated PQRI measure requirements.
- Why release notes can be useful when comparing prior and current measure specifications.
- What kinds of measure changes may affect eligible encounters and reporting options.
Who Should Read This
- Physician practices
- Medical coders
- Quality reporting staff
- Billing staff
- Compliance staff
Codes Discussed
Code Ranges Discussed
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