Guidance for the 2008 Physician Quality Reporting Initiative (PQRI) was released with the 2008 Medicare Physician Fee Schedule Final Rule in November. The reporting period for the 2008 program will be January 1 - December 31, 2008.

The rules for the 2008 program are virtually unchanged for Emergency Department Providers. The reporting requirements remain at least 80% of at least 3 of the quality measures to qualify for the 1.5% bonus on allowable Medicare charges.

The Final Rule included 119 quality measures for the 2008 program which was a significant increase from the 74 measures available for 2007. Emergency Medicine retained 10 of the 11 measures from the 2007 list available with the Specialty codes.

Measure #29: Beta Blocker at Time of Arrival for AMI (Acute Myocardial Infarction) has been deleted for 2008. The 10 measures applicable to Emergency Medicine Providers for the 2008 program are: 

Measure #28: Aspirin at Arrival for AMI - Patient documented to have had received or taken aspirin 24 hours before emergency department arrival or during emergency department stay

 

Measure #31: Stroke and Stroke Rehab: DVT Prophylaxis for Ischemic Stroke or Intracranial Hemorrhage - This measure is only linked to the 99291, Critical Care code for Emergency Medicine and does not include the ED 99281-99285 codes in the description

 

Measure #47: Advance Care Plan

 

Measure #54: Electrocardiogram Performed for Non-Traumatic Chest Pain - This refers to 12-lead ECG, not 3-lead rhythm strip

 

Measure #55: Electrocardiogram Performed for Syncope - This refers to 12-lead ECG, not 3-lead rhythm strip

 

Measure #56: Vital Signs for Community Acquired Bacterial Pneumonia - Patient documented to have had vital signs recorded and reviewed

 

Measure #57: Assessment of Oxygen Saturation for Community Acquired Bacterial Pneumonia - Oxygen saturation results documented and reviewed

 

Measure #58: Assessment of Mental Status for Community Acquired Bacterial Pneumonia

 

Measure #59: Empiric Antibiotic for Community Acquired Bacterial Pneumonia - Patient documented to have appropriate empiric antibiotic prescribed

The updated 2008 information, including detailed specifications, can be found on the CMS website at  www.cms.hhs.gov/PQRI .

After reviewing the information found on the CMS website, your group may want to review the quality measures that are currently being reported for 2007 and consider making changes for 2008. Please feel free to contact Lynne Kottman, Compliance Officer or Jennifer Gannon, Director of Coding at (210)566-5555 or (800)637-0451 for questions or concerns.