tci Medicare Compliance & Reimbursement - 2008 Issue 14

Coding Coach: Append Modifiers When Measure Isn't Met

Surprise: 'No action' still counts toward PQRI total To successfully participate in the Physician Quality Reporting Initiative (PQRI), you must include category II codes to represent the quality measure that the physician performed. But what should you do if the physician does not perform the specified quality measure on a patient whose encounter qualifies for PQRI? You should still report the visit as you would any other PQRI encounter -- just remember to include the appropriate modifier to explain why the physician did not perform the measure, says Sandra Pinckney, CPC, coder at CEMS in Grand Rapids, MI. Medicare...

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