decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 5 (May)
To earn “Pay for Performance” you will need Category II codes
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Article Overview
This article discusses the early Medicare pay-for-performance initiative, the role of CPT Category II codes in quality measurement, and how ophthalmology organizations and clinicians may be affected. It is aimed at coders, ophthalmology practices, and physicians who need to understand the broader reporting and performance-measure framework discussed by CMS and specialty groups.
Why This Topic Matters
It helps readers understand a policy and coding shift toward quality reporting and incentive payment programs, especially for specialties that may be asked to document comorbidities and performance measures.
What You Will Learn
- How pay-for-performance programs were being introduced in Medicare-linked demonstrations
- Why CPT Category II reporting was becoming relevant to quality measurement
- How ophthalmology specialty groups were involved in performance-measure development
- Which broad types of clinical measures were associated with the reporting framework
- What the article says about the demonstration project and participating physician groups
Who Should Read This
- Medical coders
- Ophthalmology practices
- Physicians
- Practice administrators
- Compliance staff
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