PQRS…Your Questions Answered!

PQRS…Your Questions Answered!

Every day at Hands on Technology we receive multiple questions that are emailed, posted on our forum, or called in to our tech support team. The PQRS update for 2013 is still confusing to many people, so we thought we’d help you out by posting answers to many of the daily questions that we receive. You can also check out the two new videos we uploaded regarding how to update your TheraOffice programs to meet the new PQRS requirements.

For starters, if you are a TheraOffice user, it is important that you update your software with the new PQRS update. If you have not updated your software after January 11, 2013, you DO NOT have the most recent update. If you are confused on how to do this, the video will help show you. If you have any further questions please feel free to post them in the comment section on the blog, or find us on Facebook and Twitter and post your questions there and we will be happy to answer!

PQRS Questions/Answers:

How do I update my software?

If you go to TheraOffice Administrator, in the upper left hand side you will see an option that says “system.” After clicking on that, scroll to the bottom where it says “ad-in manager” then proceed to the option that says “download add-ins.” At the bottom of this page you will see a button for “other add-ins,” and after clicking on that, you will have the option to click “PQRS update 2013.” Highlight that and click install. Please view the video for further assistance on how to install the 2013 PQRS update.

Is it too late to start?

No. However, you would want to start as early as possible to ensure you meet the 50% reporting threshold. Starting now will also allow you to practice before the 2015 penalty, and will help you to improve the care of your patients. Why not get a head start?

Is participating in PQRS mandatory?

Participating in PQRS is not mandatory, however, beginning in 2015, health care professionals who do not successfully participate in PQRS will be subject to penalty payments. Eligible professionals who do not satisfactorily report on data quality measures between January 1, 2013 and December 31, 2013 will be subject to a 1.5% adjustment in their fee schedule amount in 2015, and 2.0% in 2016.

Why Should I Participate?

Those who participate in the PQRS program will help improve the care of the patients they serve through the evidence-based measures. Participating in PQRS now is a way to prepare for the future. Also, a .5% financial incentive is available to participating professionals.

How many individual quality measures am I required to select?

If you choose to report individual quality measures, you must select 3 quality measures. PTs are eligible to report on 8, so it is recommended that you pick at least 4 measures in order to increase your chances of successfully meeting the requirements of the program.

How often do I need to report these measures?

It varies for each individual measure. Here is a breakdown:

Measure 126: Peripheral Neuropathy – Neurologic Evaluation This measure is to be reported a minimum of once per reporting period for patients with diabetes mellitus seen during the reporting period.

Category Risk Profile Evaluation Frequency
0 Normal Annually
1 Peripheral Neuropathy Semi-Annually
2 Neuropathy, deformity,   and/or PAD Quarterly
3 Previous ulcer or   amputation Monthly to quarterly

Measure 127: Ulcer Prevention – Evaluation of Footwear This measure is to be reported a minimum of once per reporting period for patients with diabetes mellitus seen during the reporting period.

Measure 128: BMI Screening and Follow-Up This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period.

Measure 130: Current Medications in the Medical Record This measure is to be reported at each visit during the 12 month reporting period.

Measure 131: Pain Assessment Prior to Initiation of Patient Therapy and Follow-up This measure is to be reported for each visit occurring during the reporting period for patients seen during the reporting period.

Measure 154: Falls Risk Assessment This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period.

Measure 155: Falls Plan of Care This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period.

Measure 182: Functional Outcome Assessment This measure is to be reported each visit indicating the appropriate numerator code; However, the assessment is required to be current as defined for patients seen during the reporting period. The intent of the measure is for the functional outcome assessment tool to be utilized at a minimum of every 30 days but reporting is required at each visit due to coding limitations.

For further assistance, you can refer to http://www.apta.org/pqrs/individualmeasures

Do I need to report on both individual measures and the measures group for back pain?

Although PTs are eligible to report on both the measures group and individual measures, you should select to participate either through the measures group or individual measures.

Could I report on two of the four back pain measures associated with the measures group and one of the individual measures and qualify for the incentive?

No, the four back pain measures must be reported together. Either select to participate via the measures group or the individual measures

How do I do PQRS group codes  within TheraOffice?

Do I need to register to participate in PQRS?

If you are a Medicare enrolled provider who will be participating as an individual, there is no “special” registration process.

How do I determine which CPT code to use?

For TheraOffice users, each measure will contain text explaining the question. By simply checking off which measures apply to the patient, TheraOffice will generate a list of CPT codes that will automatically be saved to your system.

Is PQRS the same as functional limitation reporting?

No, PQRS and functional limitation reporting are two different things. See our recently posted blog; “2013 Medicare Reporting and Requirements for Out Patient Physical Therapy,” for more information regarding these differences.

How do I submit more than 12 codes on my claim form?

If you have this question, please contact our tech support team, and they will be happy to answer it for you.

How do I submit codes for OT/SLP disciplines?

If you have this question, please contact our tech support team, and they will be happy to answer it for you.

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