Glitch causes carriers to reject 20 PQRI CPT II tracking codes

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a CMS-acknowledged issue affecting Physician Quality Reporting Initiative reporting at the start of the 2009 period, including which broad measure categories were involved and what providers should watch for on remittance advice. It is relevant to physicians, billing staff, and compliance teams working with PQRI submissions, carrier or MAC processing, and claim correction workflows.

Why This Topic Matters

The article helps readers understand a temporary reporting problem that could affect whether quality data submissions were accepted and how they were treated for incentive eligibility. It is useful for practices monitoring claim processing, remittance notices, and CMS reporting requirements.

Article Sections

  1. Reporting issue overview

    Introduces a CMS-acknowledged problem affecting early 2009 PQRI reporting and describes the general type of submissions involved.

  2. Affected measure categories and quality data codes

    Summarizes the measure areas and reporting categories referenced as part of the processing issue.

  3. How to verify acceptance on remittance advice

    Explains the remittance advice indicator discussed in the article and the general method used to tell whether a submission was accepted.

  4. Resubmission and correction considerations

    Describes the article’s guidance on claim corrections, timing, and the information needed to pursue a fix.

What You Will Learn

  • What type of PQRI reporting problem CMS acknowledged
  • Which broad measure groups were affected
  • How providers could check remittance advice for processing status
  • What general information is needed when seeking a claim correction
  • What considerations the article raises about resubmission versus correction

Who Should Read This

  • Physicians participating in PQRI
  • Medical coders and coding auditors
  • Billing and claims staff
  • Practice managers
  • Compliance and reimbursement teams

Codes Discussed

Code Ranges Discussed

  • CPT II: 4195F-4196F
  • CPT II: 3470F-3472F
  • CPT II: 3475F-3476F
  • CPT II: 4192F-4194F
  • CPT II: 4148F-4149F

Subscribe or sign in to view the full article.

Official DecisionHealth® Newsletter Archives includes:

  • Includes over 25,000 articles from:
    • Coder Pink Sheets
    • Part B News
    • Answer Books newsletters
  • Current newsletters added each quarter
  • Timely news and guidance vital for your practice
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to the Find-A-Code Code Information pages
  • Code Information pages link back to related articles
  • Save yourself tons of research time, find everything in one place!
Access to this feature is available in the following products:
  • DecisionHealth Coding, Billing and Compliance Library

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?