2011 CMS Physician Quality Reporting System - Tony Hamm
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2011 CMS Physician Quality Reporting System (PQRS): Teaching Doctors of Chiropractic How to Report on Measures Related to Quality Patient Care by Tony Hamm, American Chiropractic Association
![2011 CMS Physician Quality Reporting System (PQRS) ,[object Object],[object Object],*The materials and information presented on ACA webinars are independently developed and presented and do not necessarily reflect the opinions or positions of the American Chiropractic Association. All information and comment contained in ACA webinars are provided with the understanding that neither the ACA nor the presenter are engaged in the provision of legal, coding, accounting or other professional advice. Doctors are advised to seek the services of a competent professional in order to obtain such advice.](https://image.slidesharecdn.com/tonyhamm-110614154617-phpapp02/85/2011-CMS-Physician-Quality-Reporting-System-Tony-Hamm-1-320.jpg)
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2011 CMS Physician Quality Reporting System - Tony Hamm
- 26. Example of Quality-codes CMS-1500 Form 99203 98940 25 GY AT G8440
- 35. Example of Quality-codes CMS-1500 Form 99203 98940 25 GY AT G8539 97110 GP GY
- 43. Quality-code Exclusion Modifiers CMS-1500 Form 98940 739.0 G8448 739.2 AT
Editor's Notes
- "We're not perfect. It is important to compare performance and improve wherever we can."
- On December 29, 2007, the President signed the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Extension Act), which authorized the continuation of the Physician Quality Reporting Initiative (PQRI) for 2008. The 2008 PQRI reporting period is January 1-December 31, 2008. Eligible professionals who want to report for 2008 PQRI and are not already reporting quality-data codes on claims with 2008 dates of service should begin reporting as soon as possible. The financial incentive for eligible professionals who successfully report the designated set of quality measures during 2008 is 1.5% of total allowed charges for covered services payable under the Physician Fee Schedule. Financial incentives earned for 2008 reporting will be paid in mid-2009 from the Federal Supplementary Medical Insurance (Part B) Trust Fund. The 1.5% financial incentive and its funding source for 2008 are the same as for 2007. 2008 PQRI consists of 119 quality measures, including 2 structural measures. One structural measure conveys whether a professional has and uses electronic health records and the other electronic prescribing. For further information on 2008 PQRI measures and detailed specifications, click on the "Measures/Codes" link in the left-hand column on this page. The Centers for Medicare & Medicaid Services has posted a letter to Medicare beneficiaries with important information about the Physician Quality Reporting Initiative (PQRI). The letter is from Medicare to the patient explaining what the program is, and the implications for the patient. Physicians may choose to provide a copy to their patients in support of their PQRI participation. To obtain a copy of the letter, see the " Related Links Inside CMS " section below.
- Group measures? denominator
- Explain why we don’t report Group measures.
- Is the bonus the same for 2011? No, the bonus is now 1% rather than 2%.
- A quality tool in closing the loop; include performance rates, see how you compare to your peers.
- Quality date code captures clinical action related to quality activity Example: documentation of pain assessment numerator; identified patients 18 years of age or older CMTs 98940-42 denominator Translates a clinical action into a measure
- Get people in the mind-set of reporting – get credit even if you do not actually perform the measure; must remember to attach action to claim form.
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- This document can assist you with quality reporting and is available at the ACA’s website Go to: www.acatoday.org/pqri
- (moving away from pay for procedure)