Testing for PQRI Readiness

If you are planning to participate in the voluntary Physician Quality Reporting Initiative (PQRI), you should test your billing system to ensure transmission of the quality data code to your Medicare carrier.

Prior to July 1, 2007, test code “G8300” may be included on your claim(s) to test your readiness for submission. This code may be added to any claim being submitted to Medicare and should be placed in field 24D of the CMS 1500 form (or electronic equivalent). A charge of $0.00 or $0.01 should be tested to determine your software or clearinghouses ability to accept either $0.00 or $0.01.

If successful, the test code will appear on your Remittance Advice (RA) as processed by your local carrier. The code will be denied. This will also appear on the patient’s Medicare explanation of benefits as a denied charge with no patient liability.

This test code is only valid through June so if you plan to test your system, we suggest you test it as soon as possible.

Further information on testing can be found at http://www.cms.hhs.gov/PQRI/Downloads/PQRITesting.pdf

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