Urology Coding Alert

By 2015 you'll face penalties for not reporting quality measures.

If your practice is not already reporting physician quality measures, this year would be a great time to start. Don't let physician quality reporting bonuses slip through your practice's fingers -- take a look at the 2011 changes.

Keep in mind: Physician Quality Reporting is no longer an "initiative" -- and therefore, the previous acronym "PQRI" that we have used for over a year no longer applies. Instead, the program is now referred to as the Physician Quality Reporting System, or PQRS. And that's not all that's changed in the program, CMS representatives said during a Jan. 25 CMS call.

Update Your Measures

You should already be using the 2011 measures specifications, and not last year's, said CMS's Jacquelyn Kosh-Suber during the call. The 2011 guidelines are all available on the CMS Web site at www.cms.gov/pqri.

The 2011 set includes five new measures for claims and registry reporting, 11 new registry-only measures, and four new measures for electronic health record (EHR)-based reporting only, said CMS's Michelle Allender-Smith during the call.

For example: The descriptors of measures # 49 (Urinary incontinence: Characterization of urinary incontinence in women aged 65 years and older) and # 50 (Urinary incontinence: Plan of care for urinary incontinence in women aged 65 years and older) were updated for this year.

Report on Medicare Patients

Another change for this year involves reporting for non-Medicare beneficiaries. "For the 2011 measures group, for registry-based reporting in the past you were able to receive non-Medicare beneficiaries, but for 2011, the 30 patients [on whom you must report] must all be Medicare," said CMS's

Molly MacHarris during the call. "They can be unique, however -- they do not need to be consecutive."

Resources: Download the full instructions on reporting each of the measures, along with the clinical recommendations, by clicking on the 2011 Physician Quality Reporting System Measure Specifications and Release Notes link at www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp.