Monday, August 31, 2009

PQRI for physical therapists and occupational therapists

Beginning in 2009, physical therapists or occupational therapists who report on quality measures will receive a 2% bonus. The reporting period for 2009 is January 1 - December 31, 2009.

With CPT codes 97001-97546, physical and occupational therapists could report the following individual PQRI measures:

#114. Inquiry regarding tobacco use (CPT 97003, 97004)

#124. Adoption/use of electronic health records (EHR) (CPT 97001,
97002 (physical therapy evaluation),
and 97003, 97004 (occupational therapy evaluation))

#126. Diabetic foot and ankle care, peripheral neuropathy:
neurological evaluation (CPT 97001, 97002 (physical therapy

#127. Diabetic foot and ankle care, ulcer prevention: evaluation of
footwear (CPT 97001, 97002 (physical therapy evaluation))

#128. Body mass index (BMI) screening and follow-up (CPT 97001,97003)

#130. Documentation and verification of current medications in the
medical record (CPT 97001, 97002, 97003, 97004)

#131. Pain assessment prior to initiation of patient therapy and
follow-up (CPT 97001, 97003)

#134. Screening for clinical depression and follow-up plan (CPT 97003)

#154. Falls - Risk assessment (CPT 97001, 97002, 97003, 97004)

#173. Unhealthy alcohol use - screening (CPT 97003, 97004)

#181. Elder maltreatment screen and follow-up plan (CPT 97003)

"We have not recorded BMI or done a Fall assessment on a regular basis. Is there an opportunity to go back and check our documentation for this item and report that, even if this is an omission, and report forward in 2009?"

Yes - with a registry like MDinteractive you can go back and report
old PQRI 2009 data and then report forward.

Also please be aware that there is no performance requirement with
PQRI. Your providers will get 2% bonus just for reporting data. For
example if when you go back and check the BMI you find out that the
BMI was not calculated or that BMI (≥ 30 or < style="font-weight: bold;">

"How many patients need to be reported and what population to qualify
for your registry requirements?"

You need to report 3 individual PQRI measures to be eligible for the 2% bonus.
On each individual PQRI measure, you will need to report at least on
80% of Medicare patients on which that measure applies.

For example, for the BMI measure (#128) you would need to report on at
least 80% of your 2009 Medicare patients aged 18 years and older on
date of of visit with CPT 97001 and 97003.

"We have an EHR, however, within physical therapy we do not record the medications and laboratory so it's my understanding we do not meet the guidelines."

You only qualify for the EHR measure if:
- You have 97001, 97002 (physical therapy evaluation) and 97003, 97004
(occupational therapy evaluation) CPT codes.
- You are using CCHIT-certified EMR or, if not CCHIT certified, the
system must be capable of all of the following:
1) Ability to manage a medication list
2) Ability to manage a problem list
3) Ability to manually enter or electronically receive, store and
display laboratory results as discrete searchable data elements
4) Ability to meet basic privacy and security elements