PQRI from A to Z: An Ophthalmologist's Guide

In 2009 the Physician Quality Reporting Initiative (more affectionately known as PQRI) will increase their number of measures to 153 (also the total number of touchdowns NFL quarterback Roger Staubach threw during his career... coincidence?!) and we suspect you'd like to know what this will mean for your ophthalmology practice.

Where to start? You've probably consulted the harrowingly long-winded CMS website and found numerous PDFs that describe each measure and the accompanying procedure for reporting.

But because weeding through this information is about as pleasant as getting a root canal in the Lincoln Tunnel while driving at rush hour wearing a hair suit and talking on the phone with your mother-in-law, IO Practiceware has done the dirty work for you (because we like pain!) and compiled a summary of all PQRI info that relates to ophthalmology and your practice.

To view the summary, click here or the above link.

Need more? See also our articles on Auto-Coding and E-Prescribing.

Still need more? Leave a comment!

--IO

Ophthalmic PQRI Measures

IO Practiceware sifted through the 2009 PQRI measures and compiled a list of those that relate to ophthalmology practices that use EMR. Below is a breakdown of measure number, measure description, reporting procedure, diagnosis codes (to combine with office visit code), reporting code, and modifiers on those reporting codes.

By implementing IO Practiceware's EMR software, your practice automatically satisfies measures 124 and 130.

12 - POAG

• Optic Nerve Evaluation
• 365.01, 365.10, 365.11, 365.12, 365.15
• 2027F
• 1P, 3P

14 - AMD

• Dilated Macular Examination
• 362.50, 362.51, 362.52
• 2019F
• 1P, 2P, 3P

18 - Diabetic Retinopathy

• Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
• 362.01, 362.02, 362.03, 362.04, 362.05, 362.06
• 1P, 2P, 3P

19 - Diabetic Retinopathy

• Communication with the Physician Managing Ongoing Diabetes Care
• 362.01, 362.02, 362.03, 362.04, 362.05, 362.06
• 5010F and G8397, or G8398
• 2P, 3P, 8P

117 - Diabetes Mellitus

• Dilated Eye Exam in Diabetic Patient

• 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.70, 250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 250.90, 250.91, 250.92, 250.93, 357.2, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06, 362.07, 366.41, 648.00, 648.01, 648.02, 648.03, 648.04

• 2022F or 2024F or 2026F or 3072F
• 8P

124 - HIT

• Adoption/Use of EMR
• All patient encounters
• G8447, G8448
• No modifiers
  

130

• Documentation and Verification of Current Medications in Medical Record
• All encounters with patients 18 years or older
• G8427, G8430, G8507, G8428, G8429
• No modifiers.
  

139 - Cataracts

• Comprehensive Preoperative Assessment for Cataract Surgery with IOL Placement
• Encounters with patients 18 years or older
• 0014F
• 8P
  

140 - AMD

• Counseling on Antioxidant Supplement
• 362.50, 362.51, 365.52
• 4177F
• 3P, 8P
  

141 - POAG

• Reduction of IOP by 15% OR Documentation of a Plan of Care
• 365.10, 365.11, 365.12, 365.15
• 3284F, 0517F and 3285F, 0517F with 3P and 3285F, 0517F with 8P and 3285F
• 3P, 8P