Physician Quality Reporting measures consist of two major components. A denominator and a nominator. Each component is defined by specific codes described in the respective measure’s specification along with the reporting instructions and use of modifiers. Denominators The first measure component is the denominator, which describes the eligible cases for a measure or the eligible…
This is the last year eligible professionals (EPs) can earn an incentive payment for satisfactorily reporting Physician Quality Reporting System (PQRS) quality data to the Centers for Medicare & Medicaid Services (CMS), and this year’s participation in PQRS will also determine the 2016 PQRS payment adjustment. If you satisfactorily submit PQRS quality measures to CMS…
Even though it is nearly November and you may not have reported Quality Data Codes on claims this year, it’s not too late to avoid the penalty OR to earn the incentive. Getting straight to the point, the simplest method to avoid the 2015 PQRS Payment Adjustment (penalty) is to submit an appropriate Quality Data…
The Centers for Medicare & Medicaid Services (CMS) established the Physician Quality Reporting System to allow eligible professionals to participate in a voluntary quality-reporting program. Eligible professionals, who successfully report a designated set of quality measures on claims for the reporting period, receive an annual incentive payment. The annual incentive payments for the 2011 reporting…
Measure # 241 Ischemic Vascular Disease (IVD): Complete Lipid Panel and Low Density Lipoprotein (LDL-C) Control Measure # 245 Chronic Wound Care: Use of Wound Surface Culture Technique in Patients with Chronic Skin Ulcers Measure # 246 Chronic Wound Care: Use of Wet to Dry Dressings in Patients with Chronic Skin Ulcers Measure # 247…
The eligible professionals who met the criteria for successful reporting of PQRI (name changed to PQRS in 2011) will receive incentive payments for the 2010 Medicare Physician Quality Reporting Initiative (PQRI). The distribution of 2010 payments is scheduled to be completed by September 30, 2011. How can I find details about my incentive payment, such…
Currently, review contractors request medical documentation by sending a paper letter to the provider. The provider has two options for submitting the requested records either through mail paper or fax. Medicare’s Electronic Submission of Medical Documentation (esMD) pilot project gives some providers a new mechanism for submitting medical documentation to review contractors. A list of approved review…
An Electronic Health Record (EHR) is an electronic version of a patients medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data…
The Centers for Medicare & Medicaid Services (CMS) recently announced that incentive payments for the 2010 Medicare Electronic Prescribing (eRx) Incentive Program has begun for eligible professionals who met the criteria for successful reporting. Distribution of 2010 payments Medicare Electronic Prescribing (eRx) Incentive is scheduled to be completed by August 31, 2011. Effective January 2010,…
Primary Care Incentive Payment Program (PCIP) 2016 PPACA (Patient Protection and Affordable Care Act ) established the PCIP to provide incentive payments to qualified providers and practitioners for primary care services furnished between January 1, 2011 and January 1, 2016. CMS will provide a 10 percent incentive payment to primary care practitioners defined as: 1) a…
