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Presenter: Keep coding simple for PQRS
LAS VEGAS – The Physician Quality Reporting System, which pays bonuses to practitioners for demonstrating certain quality measures in the delivery of patient care, is voluntary, “for now,” according to John A. McGreal Jr., OD, in a presentation here at International Vision Expo and Conference.
PQRS will provide a 1% bonus if the requirements are met in the first year, 2011, and a 0.5% bonus in the second year. However, practitioners who do not participate in the system by 2013 will be penalized.
“Other major commercial carriers are looking at this,” Dr. McGreal told attendees. “It’s only a matter of time before they require quality coding, too.”
“The PQRS system is structured so certain codes can be used to demonstrate quality care. There are two quality measures for glaucoma, one for diabetes, two for age-related macular degeneration and four for patients with diabetes and another problem, such as diabetic retinopathy.
“Dr. McGreal recommended that doctors “dummy down” to simple codes.
“For example, in patients with diabetes, he recommends using the code 2022F, “which means you dilated the patient and performed a dilated fundus exam,” he said. “In addition, use a diagnosis code – they offer 100 of them.
““I use 250.00, diabetes without ophthalmic manifestations, if nothing is wrong,” he continued. Keep it simple.”
“Dr. McGreal said the system has been made easier. “This is not a lot of work,” he said. “And it’s only for Medicare.”
“He noted that an eye care provider cannot collect an e-prescribing and electronic health records bonus in the same year. “I recommend doing e-prescribing and PQRI this year, and EHR next year,” he said.
“E-prescribing is offering bonuses to start, but Medicare providers who do not participate soon will be penalized.
““If you didn’t already prescribe 10 electronic prescriptions in the first half of this year, you will be penalized 1% in 2012,” Dr. McGreal said. “If you don’t do 15 between now and the end of the year, you’ll be penalized 1.5% in 2013.”
“He noted the availability of a code to indicate that there are no pharmacies in your area accepting electronic prescriptions.