Pulmonology Coding Alert

You can even get credit for reporting that a patient did not meet criteria.All coding conferences this year were abuzz with talk of the Physician Quality Reporting Initiative (PQRI), but many physicians mistakenly think that adopting these reporting measures will prove too complicated.The truth: PQRI participation is not as hard as it looks, Alice Marie Reybitz, RN, BA, CPC, CPC-H, assured attendees of The Coding Institute's December conference in Orlando, Fla.In fact, you only need to report a small amount of information on select groups of patients in order to qualify for your 2 percent dividend on Medicare payments. Depend-ing on the reporting method you choose and the type of medicine you practice, you may report on three, two, or even only one measure in order to participate; but the earlier in the year you start, the better.Get a head start: The first step to earning PQRI incentive revenue is to decide which of the 153 measures you will report. Tip: After selecting your practice's measures, incorporate the corresponding measure screening forms into your medical records, advised Reybitz.Below, get the breakdown on how to meet reporting standards for two pulmonology-relevant measures. Check out the "Resources" section at the end of this article to access more information on the PQRI program.Evaluate Spirometry Results in COPD Patients: Measure 51Measure: Percentage of patients aged 18 years and older with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) who had spirometry evaluation results documented. Report this measure a minimum of once per reporting period using the most recent spirometry results in the patient record for patients seen during the reporting period.Why? Evaluation of lung function for a patient with COPD is vital to determine the degree of pulmonary impairment present and whether or not treatments are effective, points out Alan L. Plummer, MD, professor of medicine in the division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta.For the diagnosis and assessment of COPD, spirometry is the gold standard because it is the most reproducible, standardized, and objective way of measuring airflow limitation.To arrive at the numerator: Include in the numerator patients with documented spirometry results in the medical record (FEV1 and FEV1/FVC).Look for most recent documentation of spirometry evaluation results for patients seen during the reporting period; you do not need to limit the search to the reporting period. Review these options for reporting the appearance or absence of spirometry results:Option A: Spirometry Results DocumentedCode: CPT II 3023F (Spirometry results documented and reviewed)Option B: Spirometry Results Not Documented for Medical, Patient, or System ReasonsRelated modifier: Append one of these three modifiers to 3023F to report documented circumstances that appropriately exclude patients from the denominator:
• 1P --" Documentation of medical [...]