Smokin’ PQRI Pointers
Posted on 29. Jan, 2009 by in Hot Coding Topics
We’ve got the G codes you need to score your bonus, plus links to PQRI hot spots.
No butts about it: If you code and document your practice’s smoking cessation efforts, you could earn a little extra cash from CMS.
Measure 115: CMS’s Physician Quality Reporting Initiative (PQRI) has as one of its measures smoking cessation help. To participate in this measure (and earn your bonus), your office must report on the percentage of patients aged 18 years and older who are smokers and who received advice to quit smoking. This measure is to be reported a minimum of once per reporting period for all Medicare patients seen during the reporting period, (whether or not they use tobacco). There is no diagnosis associated with this measure.
Plus, Jill Young explains when ‘family’ meetings count as critical care.
Why? Performing interventions to control smoking are strategically important because smoking is the leading preventable cause of death in the U.S. Moreover, clinical interventions are known to be effective in increasing cessation rates. Recommended physician guidelines include: (1) repeated advice and support at all or most visits, and (2) delivery of cessation assistance and follow-up at all or most visits.
To arrive at the numerator: Include in the numerator patients who received advice to quit smoking. Remember, you must report the correct combination of numerator code(s) on the claim form to properly report this measure. The “correct combination” of codes may require you to submit multiple numerator codes.
Option A: Identify tobacco smokers receiving cessation intervention. (Two G-codes are required on the claim form to submit this category):
• G8455 (Current tobacco smoker) and
• G8402 (Tobacco [smoke] use cessation intervention, counseling).
Option B: If the patient is not...
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers
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