PQRI: CMS Proposes Making PQRI Reporting Easier in 2011

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains proposed 2011 changes to CMS’s Physician Quality Reporting Initiative (PQRI), including adjustments to reporting thresholds, available reporting mechanisms, measures group rules, and the relationship between PQRI and e-prescribing incentives. It also highlights CMS discussion of common reporting mistakes found in prior PQRI quarters and where providers could review related error information. The piece is relevant to eligible professionals, group practices, and coding or quality reporting staff who follow Medicare quality reporting policy.

Why This Topic Matters

PQRI participation affects incentive eligibility and reporting compliance for Medicare providers. Understanding the proposed changes and common claim-reporting errors helps practices evaluate reporting options and reduce the risk of invalid submissions.

Article Sections

  1. Proposed 2011 PQRI reporting changes

    CMS discusses proposed revisions to PQRI reporting requirements for the 2011 program year. The section covers general reporting mechanisms, participation requirements, and related policy updates tied to the Medicare Physician Fee Schedule Proposed Rule.

  2. Measures groups

    This section addresses proposed changes specific to measures groups and registry-based reporting. It also notes who may use these reporting options under the 2011 proposal.

  3. E-Prescribing Incentive Payment Not Applicable to Those Receiving EHR Incentive

    CMS explains the relationship between the e-prescribing incentive and the EHR incentive program for 2011. The section also summarizes the general reporting framework for successful electronic prescribing.

  4. Diagnosis Codes Matter in PQRI

    This section highlights CMS feedback on common PQRI reporting errors from prior quarters. It discusses the role of diagnosis information in claim-based quality reporting and references error report resources available from CMS.

  5. Common errors

    CMS identifies examples of frequent reporting errors seen in PQRI measures. The section focuses on broad categories of data quality issues rather than detailed coding guidance.

What You Will Learn

  • How CMS proposed changing PQRI reporting requirements for 2011
  • Which general reporting mechanisms were being discussed for PQRI and e-prescribing
  • How PQRI incentive policy relates to the EHR incentive program
  • What types of reporting errors CMS said were common in prior PQRI submissions
  • Where CMS directed providers to review PQRI-related error information

Who Should Read This

  • Eligible professionals
  • Group practices
  • Medical coders
  • Quality reporting staff
  • Compliance staff
  • Medicare providers

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