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Thread: Anesthesia PQRI

  1. #1

    Angry Anesthesia PQRI

    AAPC: Back to School
    Is is true that because of "MAV", measure 30 by itself, even reported over 80% of the time was not valid in 08 and 09?

    I was told yesterday, by a contrator for CMS that since in 2008 there were not "3" measures available for Anesthesia to report on, and three were necessary to get a payment, that even though we sent in 4047F,4048F etc on over 6,000 patients, we are not eligible for any payment. Does this sound true??

    and for 2009, we reported the same amount but wont get any reimbursement for that time frame either.

    I understand that for 2010, Anesthesia must bill for measures 30 or 31 AND 76or 193 to get paid.

    Im so tired of people making things so difficult to understand, no wonder so many providers give up, with the amount of cases we do everyday, its hard to put so much time into getting straight answers from websites, and humans...

    I would appreciate hearing from any anesthesia groups that have actually physcially received money for this PQRI.

  2. #2

    Question frustrated

    I feel your frustration I have yet to communicate with anyone that has been reimbursed. However i do believe for the previous years you were able to report on measure "30" only and qualify for reimbursement. Which yes I do believe that changed this year.

    I am having trouble locating clarity in reporting 4048F when the antibiotic was not given within the hour. I went to a seminar that gave us a breakdown on reasons why but I am looking for better clarification of codes (1P, 2P, 3P, 8P).

    Are you familiar with this?

  3. #3

    Default anes pqri

    I apologize, but I wouldnt want to give anyone advice considering I reported these measures about 6,500 times and have nothing to show for it....

    There is a group of guys that CMS contracted to assist providers at a company called Qualitynet that seemed to honeslty want to help. I believe they are in charge of the Inet pqri online reports also. Their number is

    I am working on getting the measure for 2010 correct but i just cant accept the fact of all the work we did for the past two years...


  4. #4


    Our company reports 4048F with a modifier 8P if antibiotics were ordered but not administered within 1 hour of the surgery start time. There are exceptions to this rule. Some antibiotics have a 2 hour time frame such as Cipro, Tequin, Levaquin, Avelox, and Vancocin. For cesarean procedures, the time starts after cross clamping of the umbilical cord, and for colonic procedures, antibiotics can be administered 19 hours before the scheduled time of surgery. I do not know about reimbursment though.

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