pablodapena wrote on Thursday, April 11, 2013:
Hello,I was wondering if anyone had successfully started using PQRS Quality Data codes and how you implemented it(Fee Sheet?)
Regards
fsgl wrote on Thursday, April 11, 2013:
Hi Pablo,
You have to set up the PQRS codes first. Go to Administration->Services->CPT4 and add as new, each PQRS code. You need to have a description and assign a penny to each code. You cannot use zero cents because it will not show up in the Fee Sheet and these codes will not reach Medicare via the clearinghouse. After you hear from Medicare, the penny charges have to be adjusted out. Because these codes are used everyday, go to Administation->Lists->Fee Sheet and add these codes under New or Established Patient. This way you can use the drop down menu and click the PQRS code that you want without having to do a search for it.
It is a lot simpler to add a PQRS code to a regular CPT4 code at the time of the visit instead of doing a big batch via the Registry.
In Ophthalmology, we have to report on 3 PQRS codes for the Meaningful Use Attestation. To retrieve the numerators and denominators these codes come in very handy because I have been unable to generate them otherwise via the Automated Measures (AMC) reports.
pablodapena wrote on Thursday, April 11, 2013:
Thanks for the quick response.Almost all of the “F” and “G” performance codes were already there.All I needed to do was to make them reportable and add the 0.01 to the standard box next to fees.Thanks!
fsgl wrote on Friday, April 12, 2013:
It was my pleasure.
juggernautsei wrote on Tuesday, May 28, 2013:
I have question about the codes.
There are two sections
Diagnosis Reporting Service Reporting
Do you know what each of these mean. I am trying to setup PQRS measures for a client and I need to mark the CPT4 and ICD9 codes. I just want to be sure that I am marking the right ones so that when the report is run. It will show up.
Thanks!
fsgl wrote on Wednesday, May 29, 2013:
Hi Sherwin,
The Diagnosis Report gives a list of patient names for a particular ICD-9 code, while the Service Report lists patient names with a specific CPT-4, or in this case, PQRS, code. There is no tally of the total number for each report and the tally must be done manually.
What is the purpose of the reports? Is it in preparation for the PQRS bonus or the Meaningful Use incentive?
If the reports are preparation for Meaningful Use Attestation, the tally of the Diagnosis Report gives the denominator while the total of the Service Report gives the numerator for the 3 Additional Clinical Quality Measures. Family Practice does not have to report on these 3 measures because they will be able to satisfy the 3 Core Clinical Quality Measures. For the specialties like Ophthalmology, where we are unable to satisfy either the Core Clinical Quality Measures or the 3 Alternative Quality Measures; we must report on the 3 Additional CQM’s.
The AMC, Automated Measure Calculations Report, does not track the Additional CQM’s. The Standard Measures Report will do that but this project has not been completed yet, therefore both the Diagnosis and the Service Reports must be run for the Additional CQM requirements.
juggernautsei wrote on Thursday, May 30, 2013:
Fsgl,
Thanks for the reply. I understand some of what you are saying. I am using version 4.1.1
When I run the Standard Measures report. It accurately tells me the right number for the Adult Weight Screening. It gives me both Denominator which is the total number of patients in the database and the numerator which is the number of patients that were recorded having their weight checked in the office.
I set the Provider relationship to encounter. Is this appropriate?
On the CQM report, what should be used for the target date?
fsgl wrote on Thursday, May 30, 2013:
You are welcome, Sherwin.
The different requirements for Meaningful Use can be very confusing. This Wiki article, although written for Ophthalmology, should help to clear some of the confusion.
It is great that you can track the Core Clinical Quality Measures from the Standard Measures report. I have been unable to track the Ophthalmic Additional CQM’s and that is why I have to use the Diagnosis and Service reports to get the numerators and denominators for the eye related CQM’s. It is wonderful that you don’t have to use the work-around.
For the the Adult Weight Screening, the denominator should be the total number of patients seen by a particular physician, not the total number of patients in the database. Otherwise you may end up with a ratio that is inaccurately low. See attachment.
Yes, Encounter is correct because you want to select all the patients that had been seen by a particular physician.
The Target Date is a bit puzzling to me because you will notice that the AMC report has a Begin and End Date. For the Meaningful Use Attestation, the physician must designate a reporting period. Cverk’s CQM Trick answers the question for a year long attestation, but not specifically for a 90 day reporting period. If I had to guess, use the end date of that reporting period.
juggernautsei wrote on Thursday, May 30, 2013:
Thanks for having this conversation with me.
I have read the wiki page you refer to before I started this conversation with you.
One thing I do understand now after having this dialog is that the Reporting Period is more than likely the quarter in which the practice is attesting for during the calendar year. It just kind of fits.
The thing that puzzles me a bit about what your a saying that as an ophthamologist the system does not calculate these measures for you. Have you tried creating a Rule?
regards,
fsgl wrote on Friday, May 31, 2013:
It is my pleasure to be of assistance. I learn new things and correct my own misconceptions in the process, so these conversations help me as well.
The reporting period is any 90 day period for the first year of attestation. For subsequent years of attestation the reporting period is the entire calendar year (365 days).
OpenEMR comes pre-loaded with the Diabetic Eye Exam measure, PQRS 117. See attachment.
I added 2 more Ophthalmic measures and carefully followed the format of 117. All the measures show up in the Patient Summary screens as Patient Reminders, but nothing shows up in the Standard Measures report. The numbers for Cervical Screening appear and I never do Pap smears!
I found out later that project 7 & 8 of the Clinical Decision Rules are not yet completed, hence no tracking of the Eye measures.
The work on the Core Clinical Quality Measures rightfully was given higher priority because there are more Internal Medicine practitioners than there are specialists. It makes more sense to finish the CDR’s for them first.
I am extremely grateful that OpenEMR is open source and that it is so versatile and chock full of modules. Despite the fact that project 7 & 8 are works in progress, I achieved Meaningful Use this past January; so I have nothing to complain about.
juggernautsei wrote on Monday, June 03, 2013:
Thanks for the reply.
I read the Clinical Decision Rules now I understand better. I see that when we create a rule that is not hard coded it will not populate the CQM. I have a physical therapist that we are creating some rules for but we will have to do like you are doing and manually calculate the percentage until the sections get completed.
Regards
jjcahs wrote on Tuesday, November 26, 2013:
Hello,
Is OpenEMR certified as an EHR for PQRS reporting purposes? I don’t see the name on the list - http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/2012QualifiedEHRDirectVendors.pdf.
If this is a current project, we are willing to help.
Also, if anybody knows of a reliable, inexpensive/free registry vendor so we can refer our clients to for PQRS reporting, please let know.
Thanks,
Jit
ACE Health Solutions
jcahn2 wrote on Tuesday, November 26, 2013:
Ahoy Jit,
Have your clients check with their specialty boards. The ABFM offers this at no cost for Board Cert family docs.
Jack Cahn MD
OEMR Board
fsgl wrote on Tuesday, November 26, 2013:
If there is a PQRS reporting module in OpenEMR, it’s in a well hidden place.
The least expensive registry for non-members on this list is the Johns Hopkins Registry, $99; but not all Measures are included. There does not appear to be any free registries for non-members/non-customuers.
Receiving the 0.5% incentive seems hardly worth it. Rather it is the avoidance of the 1.5% penalty that will kick in, starting in 2015, if reporting is not done for 2013.
A lot less trouble to submit the PQRS codes with each claim. An additional advantage is having the EOB’s as documentation of the reporting requirement having been satisfied instead of some major mishap when the PQRS data has been toasted in the registry process.
tmccormi wrote on Tuesday, November 26, 2013:
PQRS is not part of OpenEMR, however CQM reporting is substantially similar. With Stage II Meaningful use the PQRS and CQM format have been merged it will be the same process.
–Tony
fsgl wrote on Wednesday, November 27, 2013:
Claims reporting will be preserved for 2014 per this asthenopogenic document.
tmccormi wrote on Wednesday, November 27, 2013:
And this document says the same thing, but calls it CQM under Stage 2 for 2014
–Tony
fsgl wrote on Wednesday, November 27, 2013:
CMS has at least 4 different programs which utilize CPT II codes:
1.PQRS.
2.Electronic Health Record Reporting.
3.EHR Incentive Programs, Meaningful Use.
4.PQRS-EHR Reporting Pilot.
CMS does not permit participation in this pilot and 2013 Meaningful Use attestation in the same setting, see page 40 of this guide.
1,3 & 4 are distinct programs with different reporting requirements.
To muddy the waters even more; in 2014, reporting of Clinical Quality Measures, which are connected to CPT II codes, is not required for Meaningful Use attestation but recommended, see this webpage. Of the 20 requirements, 3 are Menu Measures, which have no linkage to CPT II codes.
macula wrote on Thursday, January 16, 2014:
hello fsgl
I created 2 new rules in the Administration > Rules area. One for Diabetes:Retinopathy and one for POAG:Optic nervhead exam.
The POAG rule works well and the reports show the numerator increasing.
The Retinopathy rule with i followed the guide here
http://www.open-emr.org/wiki/index.php/2013_Ophthalmologist's_Meaningful_Use_Attestation
gives me the passive alert. When I click it and enter the date via PN Calender, the alert does not disappear. The numerator in the reports is still 0.
Any thoughts? Where in the database can I delete this rule entirely so I can attempt at recreation.
Openemr 4.1.2/Centos 6.4/php 5.3.3
fsgl wrote on Thursday, January 16, 2014:
Did you save an entry in the Results/Details box?
The rule tables are on page 7.