Wiki Category II codes

[michelleaapc2012]

I know these codes are optional, but I am interested in learning more about when to report them. I'd appreciate hearing about anyone's experience.

 

[Cheezum51]

While they may be considered optional by many providers. If you don't meet certain filing requirements for them, it will result in fee decreases from CMS eventually and may count against the group for the Value Based Modifier Payment as well.

The PQRS codes can be somewhat specialty specific. For example, for optometry there are 6 main eye related codes plus some "cross cutting codes" such as smoking and blood pressure, that we use. Ophthalmology adds a few more based upon surgical outcomes.

To learn what codes may apply to the doctors you bill for, you might want to Google something like "2016 PQRS codes for (fill in the specialty)" and you'll probably get a chart that applies to what you deal with. CMS.gov most likely has an appropriate list if you search for it.

Tom Cheezum, O.D.m CPC