Part B News PQRI series: Quality measure breakdown - General Surgery and Radiology

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

Article Overview

This article reviews a set of Physician Quality Reporting Initiative (PQRI) measures relevant to general surgery and radiology, showing how the reporting framework links clinical quality measures with diagnosis and procedure coding. It is useful for coders, billing staff, and quality-reporting teams who need a broad understanding of the measures covered, the specialties affected, and the CMS-based coding references used in the table.

Why This Topic Matters

PQRI-style quality reporting depends on matching the right measure with the right clinical and claim coding elements. This summary helps readers quickly determine whether the article applies to their specialty workflow and whether it discusses the measure families and code sets they need to review further.

Article Sections

  1. PQRI measure breakdown for general surgery and radiology

    An overview of the article’s specialty-focused quality reporting chart and how it is organized for reporting purposes. It introduces the general categories of measures and the code sets used in the table.

  2. General surgery measures

    Quality-reporting measures related to surgical care, prophylaxis, and perioperative reporting. The section presents the associated reporting components for use with the specialty’s claim and quality measures.

  3. Radiology and stroke-related imaging measures

    Measures tied to diagnostic imaging and stroke-related reporting in radiology contexts. It covers the imaging-reporting categories included in the CMS update.

  4. Breast conserving surgery measure

    A measure category focused on radiation therapy reporting after breast cancer surgery. The section identifies the reporting framework and related visit and diagnosis coding references.

  5. Source and modifier note

    A brief source citation and note about exclusion modifiers referenced in the article. It provides contextual metadata for the measure table without expanding on coding details.

What You Will Learn

  • Which PQRI measure groups are covered in the article
  • How the article organizes specialty reporting for surgery and radiology
  • Which code sets are referenced in the measure table
  • What broad clinical reporting topics are included for stroke, carotid imaging, and breast surgery
  • Which exclusions and reporting modifiers are referenced in the source note

Who Should Read This

  • Medical coders
  • Billing staff
  • Quality reporting staff
  • Radiology practices
  • General surgery practices
  • Radiation oncology practices

Codes Discussed

Code Ranges Discussed

  • ICD-9-CM: 435.0-435.3
  • ICD-9-CM: 435.8-435.9
  • ICD-9-CM: 70551-70553
  • ICD-9-CM: 70547-70549
  • ICD-9-CM: 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91, 435.0-435.3, 435.8-435.9
  • ICD-9-CM: 174.0-174.6, 174.8-174.9

Modifiers Discussed


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