Pqrs question

EMACHORRO

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HELP...

When they say: " This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period". Does this mean we can only report it once per reporting period? or more than once? :confused:

Thanks
 

cblack712

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It means that if you enroll in that measure you must use it at least once.... however if you want to get paid for it (the incentive payment) you MUST put it on every medicare patient that qualifies under the measure.
 

ReginaR

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Hi. I starting doing PQRS in 2011. I am anxiously awaiting the 2011 payment. Has anyone gotten payment? Does anyone know of a way to check out within Medicare if the submitted claims were done properly?
 

maddismom

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It means that if you enroll in that measure you must use it at least once.... however if you want to get paid for it (the incentive payment) you MUST put it on every medicare patient that qualifies under the measure.

If that is so, where/when does the 50% reporting requirement come into play? It was my understanding you had to report on at least 50% of qualifying patients for reimbursement, not all. I'm just trying to clarify because it will make a difference on what we choose to report.
 

cblack712

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What it means is that if you choose to report you must do so accurately more than 50% of the time. In other words, if your doctor elects to participate in measure 10 for the stroke / stroke rehab (radiology) and reads 20 CT Head (70450) scans in a hospital setting (we will say that they are all CT Head w/o contrast - but they can do any qualifying cpt listed in the measure worksheet), and all 20 patients had a stroke or are experience stroke symptoms (again determined by the qualifying ICD-9 as listed on the worksheet) the coder would have to assign the appropriate PQRS code on a minimum of 11 of the patients for the physician to be considered accurately reporting.
Since CMS doesn't have a "form" to use to enroll in they consider a physician participating in a PQRS measure if they report a minimum of 1 qualifying patient with the appropriate measure codes.
Hope that makes sense - if not, let me know and I will try to explain it a little better
 

maddismom

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Thank you! I actually had investigated further and it actually started to make sense. Thanks again for your help!
 
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