Billing Pqri For Anesthesia

sblanchard

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I Would Like To Bill The Pqri But I Am Not Sure When To Report 407f
And 408f. Is There A Reporting Period And Do I Just Start Reporting Or Do I Have To Enroll.i Have Read Several Articles On This Matter An It Still Not Clear.
 

jdrueppel

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You just start reporting these $0 charge codes on your claims. Make sure your billing program is set up to bill $0 charge lines of service (this was an obstacle we had to work with).

Julie, CPC
 

rkris1781

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Coding specifications

First, the patient age should be 18 or above.

Code required to document a parenteral antibiotic was ordered:

A CPT Category II code is required to identify patients to be included in this measure.

CPT-II code

4047F: Documentation of order for prophylactic antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)

4048F: Documentation that prophylactic antibiotic was given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required) n CPT II

4048F–8P: Antibiotic was not given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not otherwise specified

So,if antibiotics was only ordered and not given use 4047F and 4048F-8P and if antibiotics was ordered and given use 4047F and 4048F.

The antimicrobial drugs listed below are considered prophylactic antibiotics for the purposes of this measure.
1.Ampicillin/sulbactam 2. Ertapenem 3.Aztreonam 4.Erythromycin base
5.Cefazolin 6.Gatifloxacin 7.Cefmetazole 8.Gentamicin 9.Cefotetan
10. Levofloxacin 11.Cefoxitin 12.Metronidazole 13. Cefuroxime 14.Moxifloxacin
15.Ciprofloxacin 16. Neomycin 17. Clindamycin 18.Vancomycin

Check with their trade names also.

I think this will help you.

Radhakrishnan ACS-AN
 

EllieAnn

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You rally should look up the lastest PQRI news for 2010 on the cms website- search PQRI.
For the current year:
4047F should be reported when there is NO ORDER for antibiotics.

OR

4048F should be reported when the antibiotics named in the list are given within 1 hour of surg or 2 hours if vanco. or fluoro.)

OR

4048F- 8P should be reported if administration of antibiotic was not initiated within one hour ( or 2hours if vanco, or flouro)reason not otherwise specified

OR

4048F -1P should be reported if not given for medical reason ( ex: contraindicated, or already receiving antibiotics)
 

dav4code

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AMA Worksheets for PQRI

These are very concise and helpful!

here is the one for measure 30.

http://www.ama-assn.org/ama1/pub/upload/mm/370/measure30-worksheet.pdf

Once again, just to clarify. There are 4 reporting options for measure #30:

4048F - Documentation that administration of prophylactic parenteral antibiotic was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered.

4048F 1P - Documentation of medical reason(s) for not initiating administration of prophylactic parenteral antibiotics as specified (e.g., contraindicated, patient already receiving antibiotics).

4048F 8P - Administration of prophylactic parenteral antibiotic was not initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not otherwise specified.

4047F 8P - No documentation of order for prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)
 
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