How do I submit PQRI for Medicare?

PQRI Reporting is automated (mostly)

With a diagnosis of glaucoma (365.1X) Coding for "99213"...

With a diagnosis of glaucoma (365.1X) Coding for "99213"...

Automatically bills the glaucoma code as well as the 2 tobacco codes since the Patient has MEDICARE as the primary insurance

Automatically bills the glaucoma code as well as the 2 tobacco codes since the Patient has MEDICARE as the primary insurance

The tobacco results came from the form. If you do not use the form, or it was not recorded correctly you may enter the PQRI code manually

The tobacco results came from the form. If you do not use the form, or it was not recorded correctly you may enter the PQRI code manually

Here is one way to find the list of PQRI codes ITEMS > Exams > PQRI

Here is one way to find the list of PQRI codes ITEMS > Exams > PQRI

The PQRI list

The PQRI list

The ITEMS "google like" search can find PQRI #14

The ITEMS "google like" search can find PQRI #14

Here is what happens if the patient has diagnosis 362.X and smokes when you bill "99213"

Here is what happens if the patient has diagnosis 362.X and smokes when you bill "99213"

Result

Result

If the results are incorrect you need to fix them. For example if you did not dialate diabetic patient us modifiers:

1P- "Did not dilate for medical reasons"

8P- "Did not dilate for patient  reasons"

Same as about but "did not dilate" modifier added

Same as about but "did not dilate" modifier added

OD Link defaults to the most common situation. You still need to understand PQRI.

http://www.aoa.org/PQRI.xml

http://www.cms.hhs.gov/PQRI/