Home Forums Discussions Meaningful Use A couple of questions re: MU

HI folks,

Trying to get on this bandwagon. Or highway to hell, whichever. Not sure I can still pull it off - downloaded 6.0.1 on Oct 10 or so. Have been reading the forums and learning a lot of meaningless useless stuff.

I've been submitting CPT codes on our bills to CMS for our Medicare patients since July, for the 6-month PQRS program. We don't use AC for billing or coding, so I have never entered a CPT code into AC, but we do enter ICD-9's and maintain the problem list that way We don't use the ordering functions at all. We do e-prescribe and import virtually all of our labs from Quest and CPL.

So, with that, I have a couple of questions:

1. I understand we can't get the escribe money from CMS and do MU for 2011, but can we still get the little PQRS bonus we've been working on for the last 3 months?

2. My chief area of confusion is with the "PQRS-like" portion, the 3rd leg of this mutant creature - the first 2 being the 15 core and the 5 menu items. When choosing the 3 optional reporting metrics, along with the 3 required ones, we simply have to follow the same instructions in the PQRS descriptors for the program we're already doing, right? But I probably can't do the same ones I've been tracking since July - BP control in diabetics, Hemoglobin A1c and pneumococcal vaccination - because that would require us to enter all those extra CPT-2 codes in AC as we are already doing in our billing software (we use Medware). Right? And we use an office-based Hemoglobin 1c machine, and we enter those numbers in the tracked data section , which I understand isn't picked up as a trackable lab. I'm sure that will come back to bite us one day.

Anyhow, what's the group's assessment as the easiest way for us to comply with this portion of the obstacle course? How much CPT coding must we enter into AC in order to get credit? I think based on a quick report I've done for the last 2 weeks of patients, we'll be OK except for this bit.

Thanks a lot, everyone.

Jim

Dear Jim,

I can't help you with PQRS.
Regarding Clinical Quality Measures (CQM):

1) In AC go to the Meaningful Use Wizard
2) Click on the CQM Required tab
3) Check all three of the Core CQM items. If you don't see patients that would qualify, check off one or more of the Alternate Core CQM items
4) Click on the CQM Alternate tab
5) Check off at least three items--more is ok

As you are seeing patients and writing notes in AC you need to do the following in order for the system to pick up the data:
1) When you finish your note on a patient, click "Sign-off"
2) You must click a CPT code--even if you don't use AC for billing. For office patients it's easy just to enter the appropriate E/M code.
3) Click "Sign It".

Now when you run your Meaningful Use Report (in the Wizard) you will start to see data populating the columns for the CQM lines. If you don't enter a CPT code as desribed above, the Num/Denom figures will all be "0".

You don't have to meet any particular target for CQM data--you just have to be able to capture the data to attest.

Hope this is helpful.

John,

Thank you!

So For stage I, we're just going through the motions with regards to CQM, proving that the program *can* capture data? All I need to do is be sure that I enter a CPT code like 99213 or 14 for each encounter?

I thought I saw somewhere here on the boards that folks were finding they had to enter a v-code ICD-9 that had to do with weight loss counseling in regards to one of the 3 core measures. True?

Jim

You are aware, right, that this is coming. With one of the next steps, when they have us reporting all this data and working at data collection for free, they will cut our payments if we don't meet it. For instance, if your A1c's and BP's aren't low enough, or if your patients won't quit smoking you will be penalized. This is how they will force us to lower costs for them. This government control is going to become so much worse than it is, and I'm afraid physicians will go right along with a carrot dangling in front of their noses and then a stick on their back

You are right Boondoc, about your fear. Most will go along with the carrot and stick. Since most physicians work for a corporate entity that is not their own, most will be required by their administrations to comply. Why? b/c the administrators will want the money to run the hospital or clinic. Not b/c the docs buy into the concept of collecting all this data. Don't get me wrong, there are lots out there who really want to collect the data and see this as opportunity to change outcomes.

I too can see the genius in the gov't ploy, they are manipulating us.....for as long as we choose to be manipulated. This may become the greatest disaster in U.S. healthcare. If hospitals and clinics stop participating with Medicaid/Medicare as a result of MU penalties, many will be left without healthcare.

The following is not the doctor in me talking, rather the businessman in me talking. I will collect the MU data for as long as it is profitable. If the day comes that I'm not meeting target goals in steps 2 or 3, I may withdraw from Medicare and stop MU participation. For now I'm going along with it. But if the goals are too hard for my patients to meet, I will either drop patients or drop Medicare. Either way it may end up hurting patients. But one thing can't happen: I cannot let this gov't program hurt my business.