Anesthesia Coding Alert

Pain management e-prescribers may be up for a bonus.

If your pain management doc regularly gives prescriptions to her patients, there may be bonus reimbursement lurking within the Physician Quality Reporting Initiative (PQRI). PQRI is a voluntary individual reporting program which offers an incentive payment to eligible professionals (EPs) satisfactorily reporting data on quality measures for covered Physician Fee Schedule services furnished to Medicare Part B beneficiaries. In 2009, the incentive is 2 percent of the EPs estimated total Medicare Part B Physician Fee Schedule (PFS) allowed charges. CMS is also working on the first year of the E-Prescribing Incentive Program, in which EPs indicate on their claims through special G codes whether they take advantage of the benefits of a qualified e-prescribing system.

It is not too late to participate in the 2009 PQRI and E-Prescribing Incentive Programs, says Michael T. Rapp,MD, JD, FACEP, of CMS. There is still time to qualify for both the 2009 PQRI and e-prescribing incentives.

Learn more about 2009 PQRI: Check out the PQRI Implementation Guide. This Guide tells you how to prepare to report individual measures through claims, it includes the reporting principles you need to know, [and it] provides a sample claim illustrating how to report several measures, Rapp says. You can find the Guide here: www.cms.hhs.gov/PQRI/Downloads/2009PQRIImplementationGuide.pdf.

Learn more about the 2009 e-prescribing Incentive (www.cms.hhs.gov/ERXIncentive): The E-Prescribing Incentive Program is a voluntary claims-based reporting program allowing EPs to qualify to earn an incentive of 2 percent of the professionals estimated total Medicare Part B PFS allowed charges, if the professional is a successful e-prescriber. To be considered a successful e-prescriber for 2009, you must report an e-prescribing measure on at least 50 percent of Medicare Part B claims for services furnished during the 2009 reporting period, Rapp points out. Also, to qualify to earn the incentive, at least 10 percent of your total Medicare Part B PFS allowed charges for the 2009 reporting period must be for services listed in the e-prescribing measures denominator.