tci Medicare Compliance & Reimbursement - 2007 Issue 28

QUALITY-OF-CARE: Get More Answers To Your Last-Minute PQRI Questions

Don't forget modifiers for measures that don't fit the facts.You may just be starting to submit your claims for early July, which means it's your last chance to untangle your Physician Quality Reporting Initiative (PQRI) coding dilemmas. Here are some more answers to your PQRI questions:Q: If a claim consists of just an evaluation and management visit plus a category II code for the PQRI, do we need to attach the 25 modifier to the E/M code?A: No. Since these are assessment codes and don't actually describe a "procedure," you don't need to add the 25...

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