decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 4 (April)
Ophthalmologists have eight measures for PQRI
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Article Overview
This article explains the ophthalmology portion of the PQRI quality reporting program, including the broad reporting framework, affected clinical areas, and the use of CPT Category II and Medicare G codes on claims. It is aimed at ophthalmologists, coders, and billing staff who need to understand what types of quality measures are being reported and how the program fits into Medicare quality reporting.
Why This Topic Matters
It helps ophthalmology practices recognize which quality-reporting measures are addressed in the article and understand the general Medicare PQRI context for claim-based reporting.
Article Sections
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PQRI overview and reporting basics
Introduces the quality reporting program, the Medicare context, and the general claim-reporting approach used for ophthalmology measures.
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Reporting thresholds and payment timing
Summarizes high-level participation and payment concepts, including the reporting threshold concept and the timing of bonus payments.
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Reporting PQRI
Provides a brief example of claim reporting in the ophthalmology setting and how the quality-reporting element fits alongside routine visit coding.
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PQRI Ophthalmology Measures and Codes
Outlines the ophthalmology quality measures discussed in the article, grouped by condition and care setting.
What You Will Learn
- How PQRI is framed for ophthalmology practices
- Which general ophthalmology measure areas are included in the article
- What types of claim-based reporting elements are discussed
- How the article organizes quality measures by condition
Who Should Read This
- Ophthalmologists
- Ophthalmology coders
- Medical billing staff
- Practice administrators
- Quality reporting staff
Codes Discussed
Modifiers Discussed
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