Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC PQRI section of the CMS Web site at http://www.cms.hhs.gov/PQRI/03_EPrescribingIncentiveProgram .asp#TopOfPage as soon as practical but by no later than December 31, 2008. e. Reporting the Electronic Prescribing Measure Reporting the electronic prescribing measure for 2009 is limited to claims based submission. The reporting of the measure is subject to the same technical requirements as for PQRI claims based measures in terms of the items that need to be submitted on the claim. Examples of technical requirements include submission of an NPI for the eligible professional, inclusion of the measure reporting codes on the same claim that contains the denominator codes, and no resubmission of the claims for purpose of reporting numerator codes. Detailed information on the technical submission requirements is available on the PQRI section of the CMS Web site at http://www.cms.hhs.gov/pqri. Measure #125, like other PQRI measures, has two basic elements. These include: (1) a reporting denominator (for Measure #125, this consists of a set of procedure codes) that defines the circumstances when the measure is reportable; and (2) a reporting numerator (for Measure #125, this consists of three specific codes, one of which must be reported for successful reporting.) 682
CMS-1403-FC The measure becomes applicable to a particular patient and reportable when, in billing for Part B services, the professional includes at least one of the procedure codes making up the denominator on the claim for payment (for example, a medical visit for CPT code 99213). If one of the denominator codes is included on a claim for Part B services, then the physician or other eligible professional must report one of the numerator reporting codes on the same claim to meet the reporting requirement. Where the eligible professional fails to report a numerator reporting code specified for the measure on such a claim, then the case would be included in the denominator count, but not in the numerator count for satisfactory reporting. More detailed information on the specific technical requirements for correctly reporting quality data codes is available on the PQRI section of the CMS Web site at www.cms.hhs.gov/pqri. i. Reporting Denominator. The Measure #125 denominator consists of specific billing codes for professional services. They are typically billed for services in the office or outpatient setting furnished by physicians or other eligible professionals. Currently, the denominator codes for the electronic prescribing measure are CPT Codes: 90801, 90802, 683
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<strong>CMS</strong>-1403-FC<br />
PQRI section of the <strong>CMS</strong> Web site at<br />
http://www.cms.hhs.gov/PQRI/03_EPrescribingIncentiveProgram<br />
.asp#TopOfPage as soon as practical but by no later than<br />
December 31, 2008.<br />
e. Reporting the Electronic Prescribing Measure<br />
Reporting the electronic prescribing measure for 2009<br />
is limited to claims based submission. The reporting of<br />
the measure is subject to the same technical requirements<br />
as for PQRI claims based measures in terms of the items<br />
that need to be <strong>submitted</strong> on the claim. Examples of<br />
technical requirements include submission of an NPI for the<br />
eligible professional, inclusion of the measure reporting<br />
codes on the same claim that contains the denominator<br />
codes, and no resubmission of the claims for purpose of<br />
reporting numerator codes. Detailed information on the<br />
technical submission requirements is available on the PQRI<br />
section of the <strong>CMS</strong> Web site at http://www.cms.hhs.gov/pqri.<br />
Measure #125, like other PQRI measures, <strong>has</strong> two basic<br />
elements. These include: (1) a reporting denominator (for<br />
Measure #125, this consists of a set of procedure codes)<br />
that defines the circumstances when the measure is<br />
reportable; and (2) a reporting numerator (for Measure<br />
#125, this consists of three specific codes, one of which<br />
must be reported for successful reporting.)<br />
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