# Pqri



## NESmith (Apr 27, 2010)

Can PQRI codes only be billed once a year or can they be billed at every encounter? I have some doctors stating only once and some doctors say at every encounter. Please help Thanks


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## shellott (Apr 28, 2010)

*PQRI Reporting*

My understanding is that it will depend on the measure you are reporting and how you are reporting.  Some measures are only performed once a year so should only be reported once a year for each patient that receives service.  If you are reporting PQRI Measures on a claim it should be done at the tiem of billing following the measure reporting requirements.
If you are using a registry or an EHR there may be possible to do it after the services are performed.  Here is a link I found helpful.

http://www1.cms.gov/PQRI/Downloads/2010PQRIStsfctryRprtFS032310f.pdf


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## psostand (May 12, 2010)

You only have to report on a given measure once per patient to Medicare for either the 30 consecutive patients or if you're doing the 80% reporting.


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## Stacyharter98 (May 21, 2010)

*PQRI newbie Help!*

My organization would like to start reporting PQRI. My question is if a patient comes in for knee pain, new or established, if they happen to have diabetes and they are not having any trouble with it, and or not there for a check for it do you automatically do the pqri without them having an issue with it just so you can get the measure?


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## cmcgarry (May 21, 2010)

stacy pauley said:


> My organization would like to start reporting PQRI. My question is if a patient comes in for knee pain, new or established, if they happen to have diabetes and they are not having any trouble with it, and or not there for a check for it do you automatically do the pqri without them having an issue with it just so you can get the measure?



I work for an organization with many specialty clinics (and one primary care); they choose which PQRI measures to report based on what type of clinic they are.  For example, the Internal Med clinic reports the preventive measures; endocrinology reports the diabetic measures; rheumatology reports the rheumatoid arthritis measures.  So, if a patient with knee pain reports to their PCP in IM, they would still do the preventive - even if the patient is diabetic.  However, if that same patient went to endocrinology, they would report the diabetic measures.  When a clinic/doctor chooses which measures to do, they do the same one on all qualifying patients.  The CMS website has a lot of excellent information on PQRI.

I hope this helps.


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