Physician Quality Reporting System for Urology


 

As we all know, PQRS reports on the quality of care. PQRS reports on quality measures developed by healthcare professionals at the American Medical Association, the American Podiatric Medical Association, the American Society for Therapeutic Radiology and Oncology, American Society of Hematology Oncology, the College of American Pathologist, the National Committee for Quality Assurance and many other societies.

These reports quality PQRS, earlier PQRI measures for urologist for a financial incentive. Hopefully, the reporting of this data will lead to improvement in the care of our individual patients.

Methods for Reporting PQRS

There are three methods – by quality measures. There is the claim based category reporting which will be most likely used by most urologists. There is a measures groups reporting. And also there's a registry based reporting.

Now, Claims based reporting is probably the method the most urology offices would use. Report CPT category II codes which are found in the appendix H of the CPT manual or the temporary G medical codes.These Quality measures must appear on the same claim as one uses to request reimbursement for clinical services using clinical CPT category I codes.

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Now, the Measures Groups reporting are group reporting in which the denominator of the fraction that we'll speak about is common for all of these measures. These group reportings may contain four or more quality measures.

There are seven groups. And they pertain to Diabetes Miletus, rheumatoid arthritis, chronic renal disease, coronary artery bypass grafting, preventive care, perioperative care and back pain. Months urology offices will not use the measured groups reporting.

There is also another way to report through the registry, a registry based reporting which is basically an electronic record reporting where your quality measures are reported to a vendor whose software will accumulate your quality measures and send them periodically to CMS for quality measure recording. There are only 18 quality measures which are reportable through one of these registries. And at present time, there are 31 registries.

Reporting Format

The quality measurements that we report are reported in a fraction type of format. The numerator of this fraction would be the specific clinical action, the PQRS or the quality codes.

The denominator is going to be the eligible cases, the patient’s CPT 1 category medical codes and/or the ICD 9 codes. These would be the payment codes that the individual practice is submitting for reimbursement of clinical services.

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