decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 3 (March)
PQRI: Doing the measure-applicability validation two-step
Subscribe or sign in to view the full article.
Article Overview
This article covers Medicare’s Measure-Applicability Validation (MAV) process within the Physician Quality Reporting Initiative (PQRI). It explains the general framework CMS uses for determining whether reporting professionals are subject to validation, including the broad concepts of clinical relation testing, minimum-threshold review, and exceptions for measures that do not fit standard groupings. The piece is relevant to practices that report quality measures, especially anesthesia practices and others with limited measure-reporting options.
Why This Topic Matters
Understanding MAV helps reporting practices anticipate whether their PQRI submissions may be reviewed beyond routine reporting. It is useful for coding, compliance, and quality-reporting staff who need to track CMS methodology and annual reporting-period guidance.
Article Sections
-
Measure-Applicability Validation overview
Introduces the Medicare validation process used in PQRI and describes which types of practices may be subject to additional review.
-
Step 1: Clinical Relation Test
Summarizes the first part of the validation framework and the general concept CMS uses to assess whether measures are related to a provider’s practice.
-
Step 2: Minimum Threshold Test
Describes the second part of the process and the broad threshold concept CMS applies when additional measures are considered.
-
Measures outside the cluster process
Explains that some measures are excluded from standard clustering and notes the general reasons CMS gives for those exclusions.
-
Future changes to MAV
Discusses CMS statements about possible future modifications to the validation process and how later changes would be applied.
What You Will Learn
- How CMS describes the PQRI measure-applicability validation process
- What the clinical relation test is intended to assess at a high level
- How the minimum-threshold concept fits into the validation framework
- Why certain measures may be excluded from clustering
- How CMS says future changes to MAV would be applied
Who Should Read This
- Medical coders
- Quality reporting staff
- Compliance professionals
- Anesthesia practices
- Physician practices participating in PQRI
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com