Worksheets for coding PQRI measures are available now
June 22, 2007
CMS has posted a toolkit for each of the 74 PQRI measures on its web site. These detailed worksheets and guides should answer most questions about the mechanics of reporting the PQRI codes on your claims.
Note that CMS is expecting to see most anesthesiologists report one PQRI measure only:
#30. Timing of prophylactic antibiotic - Administering physician
Measure #30, if you report it on at least 80% of your eligible cases, will qualify you for the 1.5% PQRI bonus. Reporting on at three measures is only a requirement if three or more measures are applicable to your practice. The PQRI certainly does not discourage anesthesiologists from providing pre-operative beta blockers but the relevant measure (#44) is not structured in such a way that most of you can report it accurately, at least in 2007. Note that if you did report Measure #44 some of the time, not achieving the 80% threshold for that measure might disqualify you from receiving the bonus at all even if your report the antibiotic prophylaxis measure 100% of the time.
“Measure #30 is the PQRI item applicable to anesthesiology.”
As Alexander A. Hannenberg, M.D., Vice-President for Professional Affairs explained in a June 20 e-mail to the MGMA- Anesthesia Administration Assembly (AAA):
“The beta blocker measure uses surgical CPTs as its denominator population so [#44] wouldn't be applicable to anesthesia claims on which these codes don't appear. [To avoid] dilution of the 80% formula, we elected not to request an expansion of the denominator set to include the cardiac anesthesia codes.”
Download a copy of the worksheets for Measure #30
Message from CMS
2007 Physician Quality Reporting Initiative (PQRI) Tool Kit is Now Available
2007 PQRI Tool Kit – Five Steps for Success
The Centers for Medicare & Medicaid Services (CMS) has developed a Tool Kit for the 2007 Physician Quality Reporting Initiative (PQRI) that will assist eligible professionals with successful reporting. This Tool Kit consists of some existing educational resources plus new measure-specific worksheets designed to walk the user step-by-step through reporting for each measure.
The Tool Kit is now a featured section on the CMS PQRI web page. To access the Tool Kit, visit, http://www.cms.hhs.gov/PQRI, and scroll down to the PQRI Tool Kit tab. The page serves as a “Read This First” Guide to the resources that are available to download.
The Tool Kit consists of the following:
- 2007 PQRI Physician Quality Measures
- 2007 Coding for Quality Handbook
- 2007 Code Master
- MLN Matters Article 5640 - Coding & Reporting Principles
- Data Collection Worksheets
The Tool Kit will be expanded as new educational resources become available.
Message from the AMA
[The] American Medical Association in collaboration with CMS, Mathematica Policy Research, Inc., and the National Committee for Quality Assurance, has developed participation tools. The tools are designed to:
- aid in the selection of measures by physicians and other eligible professionals wishing to participate in the program
- link to background information on the quality measures, including both the rationale and evidence base for each measure
- aid in the data collection required to report clinical performance data
For each of the 74 measures in the program, the tools are now available online at www.ama-assn.org/go/toolsMedicarePQRI
CMS also posted technical corrections to some of the program's measure specifications. Additional information can be found on the CMS website:
2007 Physician Quality Reporting Initiative (PQRI) Measure Specifications [PDF, 812KB] - Updated 06/19/07
June 18, 2007 Technical Corrections Release Notes, Version 1.1 [PDF, 19KB]