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PQRI
There is a Physician Quality
Reporting Initiative (PQRI) by CMS effective January 2008.
This initiative, also referred to as “Pay for Performance”,
will allow participants to receive a 1.5% bonus of all their
Medicare receivables.
Two of the measures, #99 and
#100, involve Pathology. To participate, you do not have to
sign up but comply with the reporting requirements in at
least 80% of the qualifying cases and bill Medicare using
specific codes and modifiers to indicate your compliance
with the pathology report requirements in such cases.
Note that your billing
company or department will be responsible for the proper
assignment of the modifiers. Participating pathologists’
reports may be audited by CMS to ensure compliance with the
measures.
Please use the below links to
familiarize yourself with PQRI and participate if you choose
to do so.
From the AMA website:
http://www.ama-assn.org/ama/pub/category/17493.html
Pathology quality measures:
#99. Breast cancer patients
who have a pT and pN category and histologic grade for their
cancer
#100. Colorectal cancer
patients who have a pT and pN category
and histologic grade
for their cancer
From CMS website:
http://www.cms.hhs.gov/PQRI/Downloads/
2008PQRIMeasureSpecs.pdf
(pathology in pages 222-237 from document)
http://www.cms.hhs.gov/PQRI/01_Overview.asp#TopOfPage
(general PQRI information)
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