decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 8 (August)
Quality reporting: Anesthesia providers: What to do if measure 76 doesn’t apply to you
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Article Overview
This article is aimed at anesthesia providers and coding/compliance staff who need to understand quality reporting obligations when a preferred claims-based measure does not seem to fit. It discusses PQRS participation, measures applicability validation, the risk of payment penalties, and the general categories of registry-based reporting options and specialty resources that may help determine an appropriate reporting path.
Why This Topic Matters
Anesthesia groups can face payment penalties if they fail to meet quality reporting requirements, even when their services do not align neatly with claims-based measures. Understanding the reporting pathways and available registry options helps practices reduce avoidable compliance and reimbursement risk.
Article Sections
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Understanding the PQRS and MAV issue
Introduces the quality reporting concern for anesthesia providers and explains why measures applicability validation is relevant when only limited claims-based reporting seems possible.
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If one claims-based measure is reported
Discusses the need to report at least one measure and the general importance of reviewing the full claims history to determine whether reporting requirements are met.
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If claims-based reporting is not available
Covers the need to consider other reporting pathways when claims-based measures are not suitable for anesthesia services and notes the general availability of registry-based reporting options.
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Choosing an appropriate registry
Describes the role of specialty societies and registry resources in helping anesthesia providers identify a suitable reporting registry.
What You Will Learn
- How PQRS reporting issues affect anesthesia providers
- Why measures applicability validation matters in quality reporting
- The difference between claims-based and registry-based reporting pathways
- How specialty organizations can help identify reporting resources
Who Should Read This
- Anesthesia providers
- Anesthesia practice administrators
- Medical coders and billers
- Compliance professionals
- Quality reporting staff
Codes Discussed
Code Ranges Discussed
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