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Written by Reed Tinsley, CPA | April 3, 2006
A cover letter to physicians has been posted to the Centers for Medicare & Medicaid Services (CMS) Physician Voluntary Reporting Program (PVRP) Web site. The letter suggests reasons why medical practices may want to participate in the voluntary program. It can be accessed at the PVRP website under "Downloads."
Along with the letter are four worksheets – one each for primary care, surgery, nephrology and emergency medicine – intended to be attached to the super bill for a clinical visit. Physicians should check the appropriate line so that billing staff can submit the appropriate G-code on the claim form. These worksheets do not contain relevant current procedural terminology (CPT) II codes. However in a separate provider education article, CMS makes clear that CPT II measures will be accepted in lieu of G-codes should practices find this method of reporting easier. Currently, of the 16 starter set measures, CPT II codes exist for six measures. The six are listed below:
- Beta blocker at time of arrival for heart attack patient;
- Hemoglobin A1c control less than 9 percent for diabetic patient;
- Low-density lipoprotein control in diabetic patient;
- High blood pressure control in diabetic patient;
- ACE inhibitor in heart failure patient; and
- Beta-blocker therapy for patient w/ prior myocardial infarction.
In addition, the letter describes the process for practices that wish to not only report quality measures but also receive confidential reports on how often applicable quality measures were performed compared with similar practices. Medical group representatives interested in receiving confidential reports are asked to register.
The article above was excerted from the MGMA Washington ConnexionTM , an MGMA member benefit providing information on regulatory and legislative issues affecting medical group practices. For more information, go to www.mgma.com.
