ED Coding and Reimbursement Alert

Here's why ERx should not be on your measures list.

If you-re itching to participate in the Physician Quality Reporting Initiative (PQRI), but don't know where to begin, check out this list of measures that might apply to your ED.

There are seven that most EDs can apply -- and one that never applies in the ED setting. When choosing PQRI measures, consider the following:

Percentage of patients, regardless of age, with an ED discharge diagnosis of AMI who had documentation of receiving aspirin within 24 hours before ED arrival or during the ED stay.

- 54. 12-Lead Electrocardiogram (ECG) Performed for Non-Traumatic Chest Pain

Percentage of patients 40 and older with an ED discharge diagnosis of non-traumatic chest pain who had a 12-lead ECG performed.

- 55. 12-Lead Electrocardiogram (ECG) Performed for Syncope

Percentage of patients 60 and older with an ED discharge diagnosis of syncope who had a 12-lead ECG performed.

- 56. Community-Acquired Pneumonia (CAP): Vital Signs

Percentage of patients 18 and older with a diagnosis of community-acquired bacterial pneumonia, with vital signs documented and reviewed.

- 57. Community-Acquired Pneumonia (CAP): Assessment of Oxygen Saturation

Percentage of patients 18 and older with a diagnosis of community-acquired bacterial pneumonia, with oxygen saturation documented and reviewed.

Percentage of patients 18 and older with a diagnosis of community-acquired bacterial pneumonia, with mental status assessed.

- 59. Community-Acquired Pneumonia (CAP): Empiric Antibiotic

Percentage of patients 18 and older with a diagnosis of community-acquired bacterial pneumonia, with an appropriate empiric antibiotic prescribed

ERx caveat: Measure 125, designed to track use of electronic prescribing, might have tempted ED providers. However, EDs are not allowed to report on this measure, relays Eli Berg, MD, FACEP, CEO of MRSI, an ED billing company in Woburn, Mass.

CMS deemed that facility-based providers such as EDs were not in a position to control whether an e-prescription-enabled medical record system was in place, and thus created a caveat for facility-based providers.

Find it online: ED coders can check out the 2009 PQRI measures at www.cms.hhs.gov/PQRI/Downloads/2009PQRIMeasuresList.pdf.