Author Topic: PQRS  (Read 1475 times)

rdmoore2003

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PQRS
« on: October 05, 2015, 04:54:22 PM »
My doctor is now an EP for medicares PQRS system.   I have been reading over information on this system and I am totally confused.   It is alot of the same thing over and over again.  Is there someone that can break this down and explain it to me like a 10 year old?   Again, I continue to read everything but it is repetitive.   Is the certified EHR system fall under the PQRS system?   

Regina

kristin

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Re: PQRS
« Reply #1 on: October 05, 2015, 07:19:38 PM »
PQRS reporting is different from having a certified EHR/EMR system, and attesting to Meaningful Use. You can do PQRS is you do not use an EHR/EMR. You can't do MU if you do not. So for PQRS, here is how it works:

There are various PQRS measure codes that need to be reported for Medicare patients. Some of them need to be reported each time a Medicare patient is seen, some of them once a year, etc, it just depends on the measure.

Not every provider can report every PQRS measure. Some measures can only be reported when a certain CPT code is billed. You should be able to find a list of reportable measures for your provider's specialty, and those will be the ones that you exclusively deal with.

There are several methods you can use for actually reporting the measure to CMS. Via claim or via registry are the two most common, to my knowledge. But there are other ways.

Once you figure out which measures your provider can report, you need to look at what each measure is for, what needs to be done by the provider during the encounter to legitimately report the measure, how frequently it needs to be reported in a given year per patient, what percentage of Medicare patients it needs to be reported on.

For instance, a commonly used PQRS measure is Measure #130, Documentation of current medications in the patients medical record. If you look at this link:

http://www.apta.org/uploadedFiles/APTAorg/Payment/Medicare/Pay_for_Performance/PQRS/2014/2014_PQRS_130.pdf

You will see it explains what needs to be done by the physician, which patients qualify, how frequently it needs to be done, and what CPT codes it can be submitted with, as well as the appropriate PQRS code to use.

Does the whole thing make a little more sense now, or no?

rdmoore2003

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Re: PQRS
« Reply #2 on: October 06, 2015, 02:27:46 PM »
Thanks Kristin.  It does make more sense now.  If you have a certified EHR/EMR, could this be used instead of the PQRS system?
Regina

kristin

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Re: PQRS
« Reply #3 on: October 06, 2015, 06:53:21 PM »
Yes, you can report the measures through the EHR if it is certified. I have you read this yet, by chance?

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Electronic-Health-Record-Reporting.html

rdmoore2003

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Re: PQRS
« Reply #4 on: October 07, 2015, 09:27:35 AM »
Thanks Kristin.  Yes, I have read it.  Our EHR is certified so we may go this route.
Regina