Optum360 coding books logo
Optum360Coding.com
    Contact Us   (7 a.m.–7 p.m. CST)
  Home > Coding Central Articles > Coding Central Articles  
Coding Central
Coding Central Home
Inside Track to ICD-10
Coding Central Articles
Code This!
Case Studies
Chargemaster Corner

Articles for:
January 25, 2018


Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More


New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More


OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More


View Article Archive

Subscribe:
To subscribe, paste this link into your preferred feedreader, or click on one of the buttons below:
 

Medical Coding News Archives

Proposed Changes to PQRI Released

 
July 15, 2010:

The Centers for Medicare and Medicaid Services (CMS) has released its proposed changes to the Physician Quality Reporting Initiative for 2011.

 

Among the key changes the agency is proposing:

  • Adding 20 new individual measures
  • Increasing the availability of reporting through electronic health records systems (EHRs) by including 12 additional individual PQRI measures in this reporting option to bring the total to 22 measures.  
  • Reducing the reporting threshold for claims-based reporting of individual measures to 50 percent. The current reporting threshold is 80 percent. 

 

In 2011, eligible providers (EPs) who successfully participate in the voluntary program can earn a 1 percent incentive payment. The incentive payment is based on total allowed charges for covered professional services paid under the physician fee schedule. 

 

The agency will also be creating a new group practice reporting option (GPRO). This reporting method would allow group practices with fewer than 200 eligible providers to report using this option. Currently, the GPRO is available only to practices with 200 or more EPs. 

 

The Affordable Care Act of 2010 (ACA) also mandates certain changes, the most significant of which is the potential implementation of payment penalties to EPs who do not participate. Under this proposed change, providers who do not satisfactorily report quality data would be subject to a payment reduction of 1.5 percent in calendar year 2015 and 2.0 percent in calendar year 2016 and thereafter. Other significant changes include:

  • Extending incentive payments for CY 2012 through 2014
  • Providing timely feedback reports. Currently, physicians complain that they cannot determine whether they are meeting the reporting requirements. Subsequently, any necessary changes to their processes cannot be made until it is too late.
  • Developing an informal process that permits CMS to review a determination that the EP did not satisfactorily submit quality data.

 

Deborah C. Hall

Clinical/Technical Editor

 

 

 
Sign in to
Your Account
USERNAME
Forgot your username?
PASSWORD
Forgot your password?
Don't have an account?
It's easy to create one.
Promo code

Have a promotional source code? Enter it here:


What is this?
Shop our catalog

Request or check out the electronic version of our latest catalog.

Medical Coding Books Winter 2018 Catalog