Oncology & Hematology Coding Alert

Make getting the 1.5 percent bonus as easy as possible If your practice is participating in the Physician Quality Reporting Initiative (PQRI) from July to December, you know you have to make PQRI coding super-efficient for it to be worth the trouble. Reality: The 1.5 percent bonus will cover only about 10 percent of this program's costs, says Easton, Conn., physician Stephen Levinson, MD, author of the American Medical Association's Practical EM:

Measure #71: Hormonal Therapy for Stage IC-III, ER/PR Positive Breast Cancer - G8381 -- For patients with ER or PR positive, Stage IC-III breast cancer, clinician documented or prescribed that the patient is receiving tamoxifen or aromatase inhibitor - G8376 -- Clinician documentation that breast cancer patient was not eligible for tamoxifen or aromatase inhibitor therapy measure - G8380 -- For patients with ER or PR positive, Stage IC-III breast cancer, clinician did not document that the patient received or was prescribed tamoxifen or aromatase inhibitor Measure #72: Chemotherapy for Stage III Colon Cancer Patients - G8372 -- Chemotherapy documented as received or prescribed for Stage III colon cancer patients - G8377 -- Clinician documentation that colon cancer patient is not eligible for the chemotherapy measure - G8371 -- Chemotherapy documented as not received or prescribed for Stage III colon cancer patients Measure #73: Plan for Chemotherapy Documented Before Chemotherapy Administered - G8373 -- Chemotherapy plan documented prior to chemotherapy administration - G8374 -- Chemotherapy plan not documented prior to chemotherapy administration Measure #74: Radiation Therapy Recommended for Invasive Breast Cancer Patients Who Have Undergone Breast Conserving Surgery - G8379 -- Documentation of radiation therapy recommended within 12 months of first office visit - G8378 -- Clinician documentation that patient was not an eligible candidate for radiation therapy measure           - G8383 -- No documentation of radiation therapy recommended within 12 months of first office visit Documentation and Coding Solutions for Quality Health Care. If a typical physician receives an extra $1,500 for all this work, this translates to 75 cents an hour.

Smart move: Refer to the "Measures/Codes" link at www.cms.hhs.gov/PQRI for the exact ICD-9 and CPT codes that make the patient eligible for PQRI reporting and other instructions for properly reporting the codes. Don't miss: Check out "Coding for Quality -- A Handbook for PQRI Participation" at www.cms.hhs.gov/PQRI/Downloads/PQRI_Coding_for_Quality_Handbook_061807.pdf or under the "Educational Resources" link on the PQRI Web site. Below are the measures reported with G codes you-re most likely to use. Stay tuned next month for relevant measures you report with Category II codes.