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Medicare Compliance & Reimbursement

PQRI:

Make Sure These Errors Don't Cause Your PQRI Bonus To Tank

Published on Fri Feb 13, 2009

CMS shows which issues sidelined these practices. Most practices would agree that a 57.2 percent success rate isn't overly impressive -- but that's exactly what the Centers for Medicare & Medicaid Services found in its recent analysis of PQRI submissions. Almost 43 percent of the quality data codes (QDCs) that practices submitted to CMS were ineligible for the PQRI bonus because physicians reported them improperly,CMS noted in a February report, "Quality-Data Code Submissions Error Report." The report analyzed PQRI submissions over the first three quarters of 2008. For 2009, the PQRI incentive payment is two percent of your physician's allowed charges under the Medicare physician fee schedule. If you'd like to keep that two percent flowing into your practice, avoid these common errors CMS found: Missing NPI CMS notes that 97,131 of the QDC submissions were missing their national provider identifier (NPI). Among the worst offenders in this category were claims [...]
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