Tuesday, July 24, 2012

PQRS Reporting for Pulmonologists

During 2012, there are three PQRS group measures that apply to pulmonologists:

Asthma
  •  #64. Asthma: Asthma Assessment 
  • #53. Asthma: Pharmacologic Therapy 
  • #231. Asthma: Tobacco Use: Screening — Ambulatory Care Setting 
  • #232. Asthma: Tobacco Use: Intervention — Ambulatory Care Setting 
Community Acquired Pneumonia (CAP)
  •  #56. Vital Signs 
  •  #57. Assessment of Oxygen Saturation 
  •  #58. Assessment of Mental Status 
  •  #59. Empiric Antibiotic 
COPD
  •  #51. Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation 
  • #52. Chronic Obstructive Pulmonary Disease (COPD) Bronchodilator Therapy 
  • #110. Preventive Care and Screening: Influenza Immunization 
  • #111. Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older 
  • #226. Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 
PQRS Group measures are easier to report than the individual measures: There is a finite number of patients to report (30) on group measures, unlike PQRS individual measures where each provider needs to report at least 80% of the patients to whom the measure applies.
For example, if a pulmonary doctor sees 100 Medicare patients with COPD during the year, she/he will need to report at least 80 of those patients on the COPD measure #51 (Spirometry Evaluation).
However, it will need to report only 30 patients on the COPD Measures Group.

I would like to suggest that it is better to report the COPD Measures Group than the Asthma Measures Group because of the age restriction on the asthma group. The asthma group only applies to patients between the age of 5 and 50. The COPD group applies to anyone older than 18. Because most patients with Medicare are older than 65, it will be easier to get the necessary 30 patients with COPD.

These measures groups can be reported with claims or using a CMS qualified registry like MDinteractive. It is easier to report PQRS with a registry because the doctor always can go back and find the missing quality information and add it to the registry. Claims missing PQRS quality codes cannot be re-submitted to Medicare.

3 comments:

  1. maggie.danhakl@healthline.comApril 17, 2014 at 10:14 AM

    Hi Paulo,

    Healthline just launched a campaign for called "You Are Not Your COPD" where COPD patients share their story or advice about living with the disease. You can see the homepage for the campaign here: http://www.healthline.com/health/copd/inspirational-stories

    We have partnered with the COPD Foundation to promote the campaign and have pledged that for every submitted story, Healthline will donate $10 to the COPD Foundation.

    I am writing to ask if you can help spread the word about this campaign by including it as a resource on your page: http://mdinteractive.blogspot.com/2012/07/pqrs-reporting-for-pulmonologists.html

    The more stories we receive the more Healthline will donate to COPD research, support, and treatment programs. Would you please consider including this on your site or sharing with your followers?

    I'm happy to answer any questions you may have.

    Thank you,
    Maggie Danhakl • Assistant Marketing Manager
    p: 415-281-3124 f: 415-281-3199

    Healthline • The Power of Intelligent Health
    660 Third Street, San Francisco, CA 94107
    www.healthline.com | @Healthline | @HealthlineCorp

    About Us: corp.healthline.com

    ReplyDelete
  2. This comment has been removed by the author.

    ReplyDelete
  3. This comment has been removed by the author.

    ReplyDelete