PQRI providers rely on EHR, other measures for bonuses

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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 explains how providers were using PQRI quality measures to pursue incentive payments, highlighting the measures and quality data codes that were most frequently billed, along with CMS program updates affecting future reporting options. It is intended for clinicians, coders, billing staff, and quality-reporting professionals who want to understand which reporting areas were most common and what program materials and CMS notices matter for upcoming reporting years.

Why This Topic Matters

PQRI participation depends on accurate quality reporting, and the article helps readers understand the reporting areas that were driving volume, the CMS resources tied to measure submission, and which program changes could affect future reporting opportunities.

Article Sections

  1. PQRI reporting trends and major reporting areas

    The opening discussion summarizes reporting volume trends and identifies the broad quality measure categories that accounted for a large share of submissions. It also introduces the reporting year context and the CMS program framework.

  2. Program updates and reporting resources

    This section discusses CMS proposed changes affecting future PQRI participation and points readers to program materials that support measure reporting. It also references where official release information can be found.

  3. CMS findings on reporting accuracy

    The article describes a CMS report on correct versus incorrect reporting for a specific measure and notes the role of invalid encounters in errors. It also mentions that the underlying measure materials list eligible procedure groupings.

  4. Top 12 reported PQRI data codes in 2009

    A table presents the most frequently billed quality data codes, associated measures, and the specialties most commonly billing them. The source note at the end comments on shared tracking codes used across more than one measure.

What You Will Learn

  • How PQRI reporting activity was trending during the cited reporting period.
  • Which broad quality measure categories were among the most frequently reported.
  • What CMS program updates were affecting future reporting years.
  • Where to look for official PQRI reporting guidance and release materials.
  • How CMS assessed reporting accuracy for one of the measures discussed.

Who Should Read This

  • Physicians
  • Medical coders
  • Billing staff
  • Quality reporting specialists
  • Practice managers
  • Compliance staff

Codes Discussed

Code Ranges Discussed


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