tci Medicare Compliance & Reimbursement - 2007 Issue 38
PQRI: Prepare For 2008 Quality Reporting Now
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Article Overview
This article covers practical CMS guidance related to the Physician Quality Reporting Initiative (PQRI), including claim submission concerns, clearinghouse issues, measure reporting timing, and where to find proposed and final measure lists for 2008. It is aimed at physicians, billing staff, coders, and practice administrators who need a general understanding of PQRI-related reporting requirements and CMS communications without relying on the premium article for the full details.
Why This Topic Matters
PQRI reporting can be affected by claim integrity, payor context, and the handling of reporting modifiers and measure data. Understanding the scope of CMS guidance helps practices evaluate their reporting workflow and prepare for the upcoming reporting year.
What You Will Learn
- How CMS addressed claim submission problems affecting quality reporting credit
- What general timing CMS described for reporting certain quality measures
- Where CMS directed practices to look for proposed and final measure information
- How CMS guidance distinguishes Medicare secondary payor claims from PQRI reporting
- What broad modifier-related guidance CMS provided for PQRI claims
Who Should Read This
- Physicians
- Billing departments
- Medical coders
- Practice managers
- Quality reporting staff
Modifiers Discussed
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