ASGE PQRI Toolbox
The Centers for Medicare and Medicaid Services (CMS) has selected 119 measures for the 2008 Physician Quality Reporting Initiative (PQRI) program. PQRI establishes a financial incentive to participate in a voluntary quality reporting program for eligible professionals who see Medicare patients. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from January 1 to December 31, 2008, may earn a bonus payment.
The PQRI program was first implemented in 2007 with a reporting period of July 1, 2007-December 31, 2007. Participants in the 2007 program expect to receive bonus payments from CMS in mid-2008.
Centers for Medicare & Medicaid Services Special Open Door Forum: 2009 Physician Quality Reporting Initiative (PQRI)
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the 2009 Physician Quality Reporting Initiative (PQRI). This conference call will be geared to those eligible professionals planning to participate in the PQRI for the first time in 2009 and will cover the basics of how to satisfactorily report the 2009 PQRI quality measures through claims-based reporting. During this Special ODF, CMS staff will discuss the basics of how to satisfactorily report the 2009 PQRI quality measures through claims-based reporting. Afterwards, there will be an opportunity for the public to ask questions.
Special Open Door Forum Participation Instructions:
Call Date: Thursday, February 12, 2009
Time: 3:00PM – 4:30PM Eastern Time (ET)
Tel: 1-800-837-1935
Conference ID: 83501646
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here.
A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website and will be accessible for downloading beginning February 20, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website.
Additional Information
For information about the PQRI, including educational products, go to www.cms.hhs.gov/PQRI.
GI Measures for 2008
Please note that the GI measures for 2008 have changed. The 2007 GI PQRI measures are not eligible for the 2008 program. Do not report 2007 measures after December 31, 2007. In addition to several general internal medicine measures, there are 2 new GI-specific measures, 7 HCV measures and 2 health information technology measures available for gastroenterologists in 2008:
- 2008 PQRI Summary (PDF)
- 2008 Measure Specifications (PDF)
- 2008 Measure Specifications - GI Only (PDF)
- 2008 Data collection Sheets – ASGE Exclusive!
ASGE has developed measure-specific worksheets that walk the user step-by-step through reporting for each measure. These worksheets may be used by the practice on a concurrent basis to collect PQRI data upon patient arrival for appointments.
- Measure #77: (PDF)
Assessment of GERD Symptoms in Patients Receiving Chronic Medication for GERD
- Measure #83: (PDF)
Testing of Patients with Chronic Hepatitis C (HCV) for Hepatitis C Viremia
- Measure #84: (PDF)
Initial Hepatitis C RNA Testing
- Measure #85: (PDF)
HCV Genotype Testing Prior to Therapy
- Measure #86: (PDF)
Consideration for Antiviral Therapy in HCV Patients
- Measure #87: (PDF)
HCV RNA Testing at Week 12 of Therapy
- Measure #88: (PDF)
Hepatitis A and B Vaccination in Patients with HCV
- Measure #89: (PDF)
Counseling Patients with HCV Regarding Use of Alcohol
- Measure #113 (PDF)
Colorectal Cancer Screening
- Measure #124 (PDF)
HIT – Adoption/Use of Health Information Technology (Electronic Health Records)
- Measure #125 (PDF)
HIT – Adoption/Use of e-Prescribing
It should be noted, however, that measures are not specialty specific and any of the 119 measures are available for a gastroenterologist to use in his or her practice.
The resources below will help you implement this program at your practice. This site will be updated as more information and resources become available. For further information also visit the PQRI homepage on the CMS website: www.cms.hhs.gov/pqri as well as on the American Medical Association (AMA) website: www.ama-assn.org/go/toolsmedicarepqri
The resources below will help you implement this program at your practice. This site will be updated as more information and resources become available.
CMS Alert - Some Clearinghouses Strip NPIs
Tools for Your Practice
Archived Conference Calls
Other Resources
CMS Alert
July 16, 2007 - It has come to the attention of Centers for Medicare & Medicaid Services (CMS) that some Clearinghouses are stripping the National Provider Identifier (NPI) prior to submission of the claim to Medicare. This will adversely affect Eligible Professionals in that these claims will not count toward PQRI participation. CMS urges Eligible Professionals that use clearinghouses to check with their clearinghouse to assure NPIs are not being stripped from claims. If the Eligible Professional determines that their clearinghouse is stripping NPIs from the claim, the Eligible Professional may want to consider other billing options.
A recent Special Edition MLN Matters article contains important nformation for Medicare providers and suppliers, including how to use the NPI correctly on Part A and Part B claims. You can view this article by visiting http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0725.pdf on the CMS website.
Tools for Your Practice
CMS has begun to roll out educational material to assist practitioners in implementing the program in their own practice. Please check back regularly as more material will be available soon.
PQRI Measure Finder Tool (Version 1.0)
Are you a gastroenterologist who also practices internal medicine? If so, you might find this new CMS resource helpful.
The Measure Finder Tool (Version 1.0) is designed to help eligible professionals and their coding/billing staff to quickly search for applicable measures and their detailed specifications. This tool will allow users to search for applicable measures based on a single code or a combination of codes.
http://www.cms.hhs.gov/PQRI/31_PQRIToolKit.asp
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