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New! Preliminary 2009 PQRI Code Master Single Source – This file includes a numerical listing of all codes included in 2009 PQRI for incorporation into billing software. The file is available as a downloadable document in the "Downloads" section below. Please note this document will be re-posted in the near future to include short descriptors with the codes. • Ensure that the practice's billing software can capture all the codes and associated modifiers used in PQRI. New! 2009 PQRI Data Collection Worksheets – Measure-specific worksheets that walk the user step-by-step through reporting for each measure are available on the American Medical Association (AMA) website. To access these worksheets, click on the AMA link in the "Related Links Outside CMS" section below. These worksheets may be used by the practice on a concurrent basis to collect PQRI data: • Identify the patients for whom PQRI measures and codes apply.
• Capture clinical information for translation into the administrative claim process.
• Integrate the measures into your practice.
• Improve quality and track reporting at the practice level, by maintaining a copy of the worksheets. 2008 PQRI Tool Kit - Steps for Success This Tool Kit includes valuable PQRI resources to assist eligible professionals in the successful integration of PQRI measurement into their practices. Tool Kit components delineated below pertain to claims-based reporting of quality data in PQRI and are available as downloadable documents in the "Downloads" and "Related Links Inside CMS" sections below. For information regarding registry-based reporting of measures, click on the Reporting link at left. CMS suggests that eligible professionals review and discuss the following materials with their staff. 1. 2008 PQRI New Reporting Options - Review: the new reporting options and criteria for reporting quality data on 2008 PQRI measures. Click on the "Educational Resources" link at left to download the New Reporting Options Fact Sheet.
- Select: the reporting option best suited for the practice: claims-based or registry-based submission of either individual measures or measures groups. Click on the link to the "2008 PQRI Participation Decision Tree" in the "Downloads" section below.
2. 2008 PQRI Measures Groups 3. 2008 PQRI Quality Measures List - A numerical listing of all 2008 measures is available in the "Measures/Codes" section page at left. - Review: the list of measures and determine which measures apply most frequently to the practice's Medicare Fee-for-Service (FFS) patients.
- Note that many PQRI measures require one-time reporting per patient per reporting period per eligible professional. (See "Patient-Level Measures Reference List" by clicking on the Educational Resources link at left to download this list).
- Select: the measures that the practice will report on Medicare claims.
- Note that if you report on fewer than three measures, and achieve a satisfactory reporting rate on those measures, the completeness of your measure selection will be subject to "Measure Applicability Validation (MAV) Process for Claims-Based Participation". For more information on the MAV, click on the "Analysis and Payment" link at left.
4. MLN Matters Article 5640 - Coding & Reporting Principles - A publication that introduces the coding and reporting principles required for successful PQRI reporting is available in the "Downloads" section below - Review, discuss, and disseminate this publication to staff.
5. 2008 PQRI Single Source Code Master - A numerical listing of all codes included in PQRI for incorporation into billing software. - Ensure that the practice's billing software can capture all the codes and associated modifiers used in PQRI.
6. 2008 Coding for Quality Handbook - A handbook that delineates coding and reporting principles and provides implementation guidelines for how to successfully report measures. - Read and discuss the principles, clinical scenarios, and implementation guidelines for each of the measures selected for reporting in PQRI.
- Develop a process for concurrent data collection so that PQRI codes are correctly identified and entered onto Medicare FFS claims.
- Review the sample workflow diagram included in the Handbook to plan any changes to workflow so that all PQRI quality data codes may be captured on claims for Medicare services.
The details of the revisions to the 2008 PQRI Coding for Quality Handbook are described in the document entitled "2008 PQRI Coding for Quality Handbook Release Notes 20080320", available in the Downloads section below. 7. 2008 PQRI Data Collection Worksheets - Measure-specific worksheets that walk the user step-by-step through reporting for each measure. These worksheets may be used by the practice on a concurrent basis to collect PQRI data. - Identify the patients for whom PQRI measures and codes apply.
- Capture clinical information for translation into the administrative claim process.
- Integrate the measures into your practice.
- Improve quality and track reporting at the practice level, by maintaining a copy of the worksheets.
The details of the revisions to the 2008 PQRI data collection worksheets are described in the document entitled "2008 PQRI Data Collection Worksheets Release Notes Version 1.5," which is available separately in the "Downloads" section below. 8. 2008 PQRI Measure Finder Tool and User Guide - The Measure Finder Tool (Version 1.2), in the "Downloads" section below, is designed to help eligible professionals and their coding/billing staff to quickly search for applicable measures and their detailed specifications. This tool allows users to search for applicable measures based on a single code or a combination of codes. The "CMS User Guide for 2008 Measure Finder Tool", also in the "Downloads" section below, provides instruction on how to use the PQRI Measure Finder Tool.
Page Last Modified: 12/23/2008 11:17:00 AM
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