PQRI: Not as hard as you think

As an orthopaedic practice, the Perioperative Care Measures Group is perfect for you.  Do you perform at least 30 cases per year for the following CPT codes (combined, not individually)?

If so, you can easily participate in PQRI and receive 2% of your Medicare allowed charges – for an average orthopaedist, that is approximately $3,700 per MD.  If you’re in a group practice, the incentive payments will really add up. 

Example:  A total hip arthroplasty is performed on a 66-year old female.  Standing orders indicate that cefazolin (or cefuroxime) is to be given within one hour prior to surgery and is to be discontinued within 24 hours after surgery and VTE prophylaxis is to be given within 24 hours of surgery.  All orders were followed for this patient – You have just met the requirements for the Perioperative Care Measures Group. 

You can report the measure either claims-based, G-codes are reported with each claim, or registry-based, pay a nominal fee and upload data into a qualified registry at the end of the year.  (Click here for a list of qualified registries)

There are other PQRI measures applicable to orthopaedists, likely already being captured through patient health history forms:

• Inquiry Regarding Tobacco Use
• Documentation and Verification of Current Medications in the Medical Record
• Unhealthy Alcohol Use – Screening

These are considered individual measures and you must report 3 measures on 80% of your Medicare allowed charges.  At this late date in 2009, registry-based reporting is your only option. 

We agree – at first glance PQRI seems an overwhelming, daunting program, but when you sift through and get to the meat of what applies to you, it is relatively painless for your practice to report. 

We’d love to hear from you!  Please contact Cheyenne Brinson at cbrinson@karenzupko.com or (312) 642-5616 to let us know that you are participating in PQRI.  We’d love to feature your practice in a case study about PQRI. 

Click here to access PQRI Resources

For more information visit our website at www.karenzupko.com or call 312-642-5616.