Oncology & Hematology Coding Alert

Question: We are trying to code for the Physician Quality Reporting Initiative (PQRI), but we-ve got several questions about how to do it properly. Are there any resources that can help us?

Arkansas Subscriber

Answer: Medicare renewed the Physician Quality Reporting Initiative for 2008. According to CMS, "Those who satisfactorily report quality-measures data on claims for services furnished Jan. 1 through Dec. 31, 2008, will earn a single consolidated incentive payment in mid-2009. The incentive payment will be 1.5 percent of total allowed charges for covered physician fee schedule services provided Jan. 1-Dec. 31, 2008. Incentive payments earned will be paid to the Taxpayer Identification Number (TIN) under which the incentive-earning professional submitted PQRI claims."

PQRI reporting can be tricky, especially initially. Discovering which measures are relevant to your oncologist can take time. Here are the best PQRI Web sites for coding information and instruction.

Medicare PQRI handbook: http://www.cms.hhs.gov/PQRI/Downloads/PQRI2008CodingHandbookandReleaseNote.zip

Medicare PQRI specifications document: http://www.cms.hhs.gov/PQRI/Downloads/2008PQRIMeasureSpecs.pdf

Medicare PQRI FAQ: http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?%20p_pv=3.945&p_prods=8%2C61%2C945&p_cats=&p_hidden_prods=&prod_lvl1=8&prod_lvl2=61&prod_lvl3=945

Medicare PQRI main page: http://www.cms.hhs.gov/PQRI/

AMA PQRI Quality Measures page: www.ama-assn.org/ama/pub/category/17493.html.

-- Technical and coding advice for You Be the Coder and Reader Questions provided by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and past-president of the American Academy of Professional Coders National Advisory Board.