Physicians May Meet Quality Measures but Lack Proof

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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 how emergency medicine and hospital-based practices can prepare for Physician Quality Reporting Initiative (PQRI) reporting. It focuses on the documentation gap that can exist even when quality measures are being met, along with workflow, reference-sheet, software, and reporting considerations for practices working to support PQRI submissions.

Why This Topic Matters

The article is relevant to practices trying to report quality measures accurately without relying on incomplete chart documentation. It helps coders, billers, and physician offices understand the operational areas that affect PQRI reporting readiness.

Article Sections

  1. Successful practices offer these tips to preparing for PQRI

    Introduces the article’s focus on practical preparation for PQRI participation. It frames the discussion around emergency department coding and documentation support.

  2. Reference sheet

    Describes using internal reference materials to support quality measure reporting. It also discusses bringing together diagnosis information and related PQRI measure references.

  3. Make Room for Quality Measure Recording

    Addresses workflow and documentation placement issues in physician and hospital-based settings. It emphasizes creating a clear place for quality measure documentation within the practice process.

  4. Check PQRI Software Options to Ease Your Compliance Headaches

    Covers software-related considerations for supporting PQRI reporting. It discusses system configuration, electronic documentation support, and handling reporting entries within billing workflows.

What You Will Learn

  • How PQRI participation can be supported through better documentation workflows
  • Why hospital records and physician notes may need to be reconciled for quality reporting
  • What kinds of internal reference materials may help coders and physicians
  • How software setup can affect reporting readiness
  • What general categories of reporting modifiers are discussed in relation to PQRI

Who Should Read This

  • Emergency department coders
  • Physician office staff
  • Hospital-based practices
  • Billing professionals
  • Compliance and reimbursement staff

Modifiers Discussed


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