The physicians quality reporting initiative: measure development, implementation and current procedural terminology coding.
The Physicians Quality Reporting Initiative (PQRI) was instituted in the latter half of 2007. PQRI is a voluntary reporting system in which the aim is to improve patient care, whereas at the same time, an eligible practitioner may receive an incentive payment for successful participation. Two pathology-specific measures were instituted in 2008; 1 for breast cancer reporting and the other for colon cancer reporting. In 2009, Current Procedural Terminology Category II code 3250F was instituted, which allows proper coding of cases from metastatic sites when ICD 9 code and Current Procedural Terminology Category I inclusion criteria are met. After the review of the 2007 data obtained from other specialties, submission of invalid codes was predominantly attributed to failure to adhere to measurement specifications. With increased awareness and experience, the amount of invalid code submission will decrease. More performance measures would be needed to make the program available to more pathologists. PQRI is thought by many to be the first step in transforming to a Pay for Performance Program.
Myles
Jonathan L
JL
Cleveland Clinic, OH 44195, USA. mylesj@ccf.org
Shamanski
Fay
F
Witte
David
D
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000191:economics; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery; D039702:Current Procedural Terminology; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary; D010338:Pathology, Clinical / Q000191:economics; D010820:Physicians / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics; D012052:Reimbursement, Incentive / Q000191:economics; D014481:United States