PQRI Reporting Update

As more providers consider participating in the 2009 Physician’s Quality Reporting Initiative (PQRI), the number of questions about participation rises.

Many have heard about “measures groups” and see this as an easy way to satisfy the requirements and secure the bonus. Measures groups require reporting on a small number (30) of consecutive patients with a particular systemic disease. It requires performing a series of several measures on each of these patients. At the present time, there are NO measures groups applicable to ophthalmologists. Measures groups reporting is not a feasible option.

A second common inquiry relates to Medicare as a secondary payer. Are those patients eligible for PQRI? Yes. You should report quality measures when Medicare is a secondary payer as well as on Railroad Medicare claims. Be sure to verify that the quality measure codes cross over from the primary payer to Medicare as a secondary payer.

Additional information on PQRI can be found on the CMS website @ www.cms.hhs.gov.

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