decisionhealth Newsletters, Part B News - 2007 Issue 6 (June)
Top PQRI official: Test active quality codes before July 1
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Article Overview
This article covers early Medicare Physician Quality Reporting Initiative (PQRI) implementation guidance from CMS, focusing on when test reporting should occur, why only certain quality codes are active before the program start date, and how practices can verify claims processing ahead of the reporting period. It is relevant to physicians, coders, billing staff, and practice managers who need to understand the general workflow and system-readiness issues involved in PQRI participation.
Why This Topic Matters
Practices preparing for PQRI needed to know which reporting elements were active, how carriers would handle test claims, and what operational checks could be done before the program began. The article also gives broader context about reporting thresholds, multiple practice settings, and anticipated future direction of quality reporting.
What You Will Learn
- How PQRI test reporting fit into the pre-launch implementation timeline
- What broad types of quality codes were discussed for system testing
- How practices could confirm that claims processing was working as expected
- What general reporting and participation issues CMS was emphasizing for early PQRI adopters
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Quality reporting staff
Codes Discussed
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