CMS Announces Performance Measures for 2009 PQRI
With the release of the Medicare Physician Fee Schedule final rule on Oct. 31, 2008, the Centers for Medicare and Medicaid Services announced performance measures that will be included in the Physicians Quality Reporting Initiative (PQRI) in 2009.
Although eight new measures were developed in late 2007 for diagnostic radiology, only two of these are included in PQRI 2009. The two new measures included are “Inappropriate Use of BIRADS 3” and “Recording of Fluoroscopy Time for Procedures Using Fluoroscopy”. This brings the total count of measures potentially reportable by diagnostic radiologists to four; two measures related to stroke imaging have been included in PQRI since 2007. Additionally, there are seven measures that may be reported by interventional radiologists (no new measures for 2009), six for radiation oncologists (three new ones), and one nuclear medicine measure — the first one nuclear medicine physicians can report. To see a list of these measures, click here.
The eight radiology measures that were developed collaboratively through the AMA Physicians Consortium for Performance Improvement (PCPI) and the ACR were reviewed by the National Quality Forum (NQF) mid-2008. To see this measure set, click here. The statute authorizing PQRI requires performance measures to be endorsed by NQF. The NQF reviewed the eight radiology measures, and last month endorsed four of them. The CT Dose Reduction measure, which CMS had included in the MPFS proposed rule earlier this year was not endorsed. With no endorsement from NQF, CMS dropped this measure from the final list. Although one other radiology measure was endorsed by the NQF, “Reminder System for Mammograms”, CMS did not include this in the PQRI list for 2009.
One of the eight radiology measures is actually an expanded revision of the Stroke Carotid Imaging measure included in PQRI since 2007. This measure was revised to include all patient populations, not just those with stroke. The NQF endorsed the revised version. CMS continued to include the Carotid Imaging measure in 2009.
Also undergoing review by the NQF were two measures developed by the PCPI and the Society for Nuclear Medicine (SNM). Click here for NM measure set. One of the two measures, “Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy”, was endorsed by NQF and is the one measure in PQRI 2009 for nuclear medicine physicians. Earlier in 2008, new Oncology and Prostate Cancer measures were reviewed by the NQF, resulting in endorsement of the three new measures included in 2009 relevant to radiation oncology practices. These are “Plan of Care for Pain”, Pain Intensity Quantified” and “Tissue Dose Constraints”. Click for the Oncology Measure set and the Prostate Cancer set.
Guidance for use of CPTII codes for measure reporting can be found in the ACR September/October Radiology Coding Source™.
Final measure specifications, including the updated Carotid Imaging specifications and additional information such as measure toolkits will be forthcoming from CMS. Visit http://www.cms.hhs.gov/PQRI/ for updates.
Also continue to visit the ACR Web site for radiology-specific information and updates. Questions may be sent to P4Pquestions@acr.org.
