Annual Review of 2015 PQRS Individual Measures for LTPAC

January 7th, 2015 by Rod Baird

Annual Review of 2015 PQRS Individual Measures for LTPAC

The CMS documentation for PQRS measures, and the timeliness of publication, continues to improve.  For 2015, the initial specifications were out on November 11th, 2014.  The only tool that’s still missing is a handy ‘look-up’ function that would list PQRS measures (both individual and group) that apply to particular CPT/HCPCS codes.

Until CMS publishes that kind of tool, we’ll keep publishing an annual blog post of LTPAC specific PQRS Measures.  Today’s post covers individual measures, subsequently we’ll focus on Measures Groups, and the GPRO program.

Assuming you work in LTPAC Settings and use E&M codes, there are more than 9 individual measures that are available.   So you are required to report on a minimum of 9 if you elect to use Individual Measures as your 2015 PQRS reporting option.  Other options remain available which we’ve covered in the past (Registry, eCQMs, GPRO), and will review again in the near future.

A significant change, that can sneak-up on the unsuspecting, it the new requirement that that providers reporting via individual measures select at least one (1) that is Crosscutting.  The attached chart denotes the measures with that added applicability.  Two popular LTPAC eligible individual measures, Influenza Vaccination, and Advanced Directives (a/k/a Care Plan) are designated as crosscutting.

EHR users may have additional individual eCQMs available for use.  The availability depends on how their Vendor elected to construct/map their eCQM menu.

Access the Report:          There are a total of 35 Measures that apply to the some or all of the Nursing Home Code family (99304-99318).  This is a decline from the 41 total in 2014.  There was more turnover than the net change of <6> implies:

CHANGE Measure # and Concept
New 2015 Measures for SNF/NF #91 & #93 -Acute Otitis,#387 – HepC,
Deleted Measures from 2014 #197 – CAD#245 & 246 – Chronic Wound Care,#123 – CKD,#2 & #18 – DM,#266 & 267 Epilepsy,#198 – HF

 

Report Structure: The 2015 LTPAC individual Measures List we assembled displays the following fields – as you can see, CMS is trying valiantly to move all of their diverse Quality Programs towards a unified strategy.  The number of headings is illustrative of just how far they have yet to go.

 

PQRS Measure Family Measure #
CPT Code 99304- 99306
99307- 99310
99315 – 99316
99318
99324- 99328
99334- 99337
99341- 99345
99347- 99350
PQRS
Measure Title
CMS
Measure Number/Description NQF
PQRS
Measure Description
NQS Domain
Measure Type
#1
Measure Developer/Steward #2
#3
Claims
CSV
EHR
Reporting Method(s) GPRO
(Web Interface)
Measure Groups
Registry
Measure Group(s)
Crosscutting Measures
ACO
AQA
Use in Other Reporting Program(s) Meaningful Use I
Meaningful Use II
Million Hearts
Where to find the measure specification: Measure Specification Documents Link
Page #

 

Happy New Year and Best Wishes for a high quality 2015!

Rod Baird

About Rod Baird

Rod Baird is the Founder and President of Geriatric Practice Management (GPM). Since 1977, he’s led provider and management organizations that deliver care to Medicare/Medicaid beneficiaries. Past programs he’s overseen include home health, personal care, hospice, rehabilitation hospitals, adult and psych daycare, alcohol/drug rehabilitation, industrial medicine and primary care practices. The Centers for Medicare and Medicaid Services (CMS) selected Baird as one of only 73 individuals to serve with its InnovationProgram. His educational background includes a Master’s Degree in Physical Chemistry from the American University, Washington, D.C.

We're ready to help you. Contact us today by phone at (828) 348-2888, or get in touch via our contact form.