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Pulmonology Coding Alert

READER QUESTIONS:

Dispel PQRI Participation Mysteries With These FAQs

Published on Wed Jan 28, 2009

Question: Reporting on these measures sounds complicated and I am not sure my office has the time. What do I have to do to get started? And how much do I have to report to earn my 2 percent payment on Medicare billing?

Michigan Subscriber

Answer: Your practice does not need to "sign up" or register to take part in the PQRI initiative. You just begin sending your claims with the proper codes and you are part of the program. Keep in mind that the later you begin, the less money you will be entitled to from the bonus program.

As far as what you need to report, for claim-based submissions, you have two full-year participation options in 2009:

• Report at least three measures (or one to two measures if less than three apply to the eligible professional), or

• Report all measures in one measure group,documented either for:

• 30 consecutive Medicare Cases from Jan. 1 through Dec. 31, 2009 (note that this consecutive patient count must include some Medicare Part B Fee-for-Service beneficiaries), or

• 80 percent of applicable Part B FFS patients for each eligible professional (with a minimum of 30 patients) during the Jan. 1 through Dec. 31, 2009, reporting period.

For registry-based submissions, you must report:

• All measures for one measure group for 30 consecutive patients, or

• All measures for one measure group for 80 percent of applicable Medicare Part B FFS patients for each eligible professional with a minimum of 30 patients.

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