PQRS: Group or Individual Reporting – The Decision is over!
July 7, 2016
Written by Sarah Leake
The June 30th deadline for Group Reporting Option is past! Congratulations on completing this milestone in the PQRS reporting process. What is a next step in the PQRS Process? Measure selection is a valuable next step and provides an opportunity to align with other quality reporting programs in your organization. A focus on common measures for monitoring and reporting can contribute to efficiency in data collection and improved outcomes.
During the June Learning and Action Network webinar, a tool was demonstrated that can assist with measure selection – 2016 Physician Quality Reporting System (PQRS) Single Source Code Master. The 2016 PQRS Single Source Code Master is useful to find measures by codes billed by individuals or groups. It is a listing of all denominator and numerator coding for each “claims and registry measure” which can be sorted by CPT (C4), CPT II (claims reporting), ICD-10 (I10) and HCPCS.
Leave a reply, ask a question or share information using the “Leave a Reply” section below, or email Sarah Leake directly with your questions or comments.
Subscribe to the HTS PQRS Blog
Subscribe
See a list of upcoming webinars
Check out any webinars you missed
Will PQRS code added to the patient based on CPT alone or ICD alone or combination? so will it be multiple entries for one patient??
Each quality measure has a specification which lists inclusion and exclusion criteria for the denominator in addition to defining the criteria for any given patient encounter to appear in the numerator. This criteria can cover a range of information such as CPT codes, ICD codes, specific values, age, and sex.
For quality measures which can be reported using the claims reporting method, the measure specification sheets will list the appropriate Quality Data Code (QDC – CPT II codes or G codes) which must be included to obtain a performance score on a quality measure. While the claim itself will contain CPT codes and ICD codes, to count for quality measure reporting purposes, the claim must contain the appropriate QDC (CPT II or G codes) to meet the data completeness standard for claims reporting. If you are reporting for multiple measures, you would see multiple entries for a given patient as the specifications for each quality measure are unique to that measure.
We would be happy to talk with you in person should you have additional questions. Please contact us at qualitypaymenthelp@mpqhf.org for further assistance.