Gastroenterology Coding Alert

Medicare will still accept these patients toward PQRI total. Your gastroenterologist performs a service for a patient with hepatitis C that might qualify for the physician quality reporting initiative (PQRI). However, the patient refuses the proscribed PQRI treatment, saying they are forbidden by his religion. What to do: Report the measure as you would have otherwise, with a modifier 2P (Performance measure exclusion modifier due to patient reasons) appended to the E/M code. Why? Providers will receive credit for PQRI measures whether modified or not, confirms Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA's CPT Advisory Panel. Modifiers Vital for Non-Participatory Patients Any time your gastroenterologist treats a patient that qualifies for PQRI, even if the described treatment isn't performed, it will count toward your PQRI total -- provided you list one of the following modifiers, depending on the situation: • 1P" Performance measure [...]