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Trouble With PQRI? Get Our Professional's Assessment

Published on Wed Jan 28, 2009

If you're still trying to get a handle on this year's PQRI (Physician Quality Reporting Initiative) codes, you aren't alone. Scott Groudine, MD, tackles a question about a back pain code that may apply to your practice. Question: How are codes 0525F and 0526F billed in conjunction with 1130F , and what are the codes used for? Florida Subscriber Answer: The codes you are questioning are among the new 2009 Category II CPT codes used by Medicare to report on the PQRI. Medicare is the only payer that has incentive payments associated with reporting these tracking codes. Other payers might accept these codes when reported on a valid claim, but currently do not process any of these tracking codes for payment. What that means in 2009: CMS states that, The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275) made the PQRI program permanent, but only [...]
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