Download Participating in the Physician Quality Reporting

Participating in the Physician Quality Reporting
System Using OfficeMate/ExamWRITER
In this document:
For more detailed
information about
the PQRS, go to
www.cms.gov/
PQRS.
•
PQRS Overview, 2
•
Reporting Period, 2
•
Payment Adjustments, 3
•
Reporting Requirements, 3
•
PQRS Measures, 3
•
Setting Up PQRS Codes & Preferences, 5
•
Coding for PQRS Measures in ExamWRITER, 13
•
Recording PQRS Codes on Fee Slips, 37
This document explains what the Physician Quality Reporting System (PQRS) is and describes how you can use
OfficeMate/ExamWRITER 12.0 and above to code for PQRS measures so that you can later submit PQRS measure data to
the CMS through your Medicare Part B claims or to a PQRS reporting registry. This document highlights the PQRS
®
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
PQRS Overview
measures for which ExamWRITER autocodes the qualifying codes, but you can use ExamWRITER to record data for PQRS
measures not included in this document.
NOTE
PQRS Overview
While registry reporting options may be available by the end of the year, Eyefinity recommends continuing to
use the claims-based reporting option in 2016, meaning you will satisfy your PQRS requirement by including
level II CPT codes on your Medicare claims. When registry options become available, you may transition away
from claims-based reporting.
The Physician Quality Reporting System (PQRS) is a program in which physicians report metrics for specific measures to
the Centers for Medicare and Medicaid Services (CMS). Each measure relates to medical services provided to patients
whose primary insurance is Medicare.
Physicians and group practices must participate in PQRS by satisfactorily reporting measures appropriate to their practice
to avoid Medicare payment penalties. CMS is no longer offering incentive payments for participating in the program.
To see the list of
current PQRS
measures or to learn
more about the
PQRS, go to
www.cms.gov/
PQRS.
To avoid Medicare payment adjustments, you must report data for at least nine individual measures across three National
Quality Strategy (NQS) domains from the current Physician Quality Reporting System (PQRS) Measure Specifications
Manual for Claims and Registry Reporting of Individual Measures document. After recording PQRS-relevant data in exams
in ExamWRITER, you can submit PQRS data to CMS through your Medicare Part B claims or to a PQRS reporting registry.
NOTES
• Eyefinity recommends continuing to use the claims-based reporting option in 2016, meaning you will
satisfy your PQRS requirement by including level II CPT codes on your Medicare Part B claims. CMS is
promoting the use of registry reporting in 2016, but the claims-based reporting option is still available.
• CMS offers different reporting programs and incentives. Each program has different criteria and tracks
different measures. The measures tracked by the PQRS are not the same as those tracked by the EHR
Incentive Program. For more information on the different incentives offered by the CMS, go to
www.cms.gov.
Reporting
Period
2
PQRS measures your performance throughout the calendar year—from January 1 to December 31—each year.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Payment Adjustments
Payment
Adjustments
Failure to satisfactorily report data on quality measures will result in a reduction in Medicare payments. The participation
year, reporting year, and the Medicare payment penalty year are staggered so that penalties take effect two years after the
participation year. For example if you participate throughout 2015, you’ll report your results by February 29, 2016, to avoid
a 2% payment penalty in 2017.
Reporting
Requirements
Nine individual measures covering at least three NQS domains for at least 50% of Medicare Part B FFS patients.At least
one measure must be a cross cutting measure.
PQRS
Measures
PQRS tracks many measures relating to different areas of healthcare. These measures may change on an annual basis. All
PQRS measures are described in full detail in the current Physician Quality Reporting System (PQRS) Measure
Specifications Manual for Claims and Registry Reporting of Individual Measures document; to see this document and a full
description of each measure, go to www.cms.gov/PQRS.
ExamWRITER offers the ability to autocode for measures that are most likely to be reported by eyecare professionals. This
document highlights the PQRS measures for which ExamWRITER autocodes the qualifying codes, but you can use
ExamWRITER to record data for PQRS measures that are not included in this document.
ExamWRITER autocodes for the PQRS measures described in the following table:
PQRS
NQF
Number Number
Numerator
Measure Description
Codes
12
0086
2027F
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation Effective Clinical
Care
14
0087
2019F
Age-Related Macular Degeneration (AMD): Dilated Macular
Examination
Effective Clinical
Care
19
0089
5010F
G8397
G8398
Diabetic Retinopathy: Communication with the Physician
Managing On-Going Diabetes Care
Effective Clinical
Care
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Quality Strategy
Domain
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
PQRS Measures
PQRS
NQF
Number Number
Numerator
Measure Description
Codes
Quality Strategy
Domain
117
0055
2022F
2024F
2026F
3072F
Diabetes: Eye Exam
Effective Clinical
Care
130
0419
G8427
G8428
G8430
Documentation of Current Medications in the Medical Record
Patient Safety
140
0566
4177F
Age-Related Macular Degeneration (AMD): Counseling on
Antioxidant Supplement
Effective Clinical
Care
141
0563
3284F
3285F
0517F
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Communication
Pressure (IOP) by 15% OR Documentation of a Plan of C
and Care
Coordination
226*
0028
4004F
1036F
Preventive Care and Screening: Tobacco Cessation Intervention
Community/
Population
Health
317
—
G8783
G8950
G8784
G8785
G8952
Preventive Care and Screening: Screening for High Blood
Pressure and Follow-Up Documented
Community/
Population
Health
* CMS designated cross-cutting measure
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
Setting Up
PQRS Codes
& Preferences
This section tells you how to set up codes and preferences in OfficeMate Administration and ExamWRITER Administration
so that ExamWRITER can autocode for PQRS measures, including how
•
To set up qualifying diagnosis codes, 5
•
To set up level II procedure codes, 7
•
To create services for level II procedure codes, 8
•
To set up modifiers, 9
•
To set up level II procedure code reminders, 11
•
To automate PQRS coding, 12
NOTES
• Some or all of the level II CPT codes may be included in your OfficeMate/ExamWRITER procedure codes
list. The latest codes are included in new installations of OfficeMate/ExamWRITER, but are not updated
when existing installations are upgraded. You must verify that each of the level II CPT codes is included in
your database. Create new services in the Products window and select the appropriate new level II
procedure codes from the CPT drop-down menu. You must complete these tasks in order for the new level
II procedure codes to be autocoded in ExamWRITER and recorded on fee slips in OfficeMate. For
information on creating new services, refer to the “Maintaining Product & Service Information” chapter of
the OfficeMate Administration User’s Guide.
• After designating PQRS diagnosis codes and level II procedure codes and selecting to autocode PQRS
codes for select insurance companies, you will not receive a warning on fee slips on which the insurance
company is billed, level II procedure codes are recorded, and $0 fees are billed. Also, you will not receive
the “Line Item cannot have ZERO” error in the Third Party Processing window. If all of the items on an
insurance claim are level II procedure codes, then you can submit a $0 balance insurance claim.
 To set up qualifying diagnosis codes
1. From the OfficeMate Administration main window, click Setup.
OR
If you are using ExamWRITER Administration, click Activities.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
2. Select Third Party Setup.
The Third Party Setup window opens.
3. Click the Diagnosis Codes tab.
4. Select a code from the list.
OR
Add a new code.
5. Select the PQRI (Voluntary) check box to designate the diagnosis code as a PQRS code.
6. Click Save when you are finished.
7. Click Exit to close the Third Party Setup window.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
 To set up level II procedure codes
1. From the OfficeMate Administration main window, click Setup.
OR
If you are using ExamWRITER Administration, click Activities.
2. Select Third Party Setup.
The Third Party Setup window opens.
3. Select a code from the list.
4. Click Save when you are finished.
5. Click Exit to close the Third Party Setup window.
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Setting Up PQRS Codes & Preferences
 To create services for level II procedure codes
After you designate the procedure code as a level II procedure code, you must set up the code as a service so that it
displays in the ExamWRITER Diagnosis/Procedure Coding window.
1. From the OfficeMate Administration main window, click the Products icon and select Products and Services.
The Products window opens.
2. Select Services from the Product Type drop-down menu.
3. Click New Product.
4. Type the level II procedure code in the Product Name text box.
5. Type the name of the level II procedure code in the Print on Fee Slip text box.
6. Click the Product Details tab.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
7. Select the level II procedure code from the CPT drop-down menu.
8. Click Save and select Save and Exit.
 To set up modifiers
1. From the OfficeMate Administration main window, click Setup.
OR
If you are using ExamWRITER Administration, click Activities.
2. Select Third Party Setup.
The Third Party Setup window opens.
3. Click the Modifiers tab.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
4. Click New Modifier to create a new code.
OR
Select a code from the list.
5. In the Code (Box 24d) field, type the procedure modifier code.
6. In the Description text box, type a short description for the modifier.
7. Click Save when you are finished.
8. Click Exit to close the Third Party Setup window.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
 To set up level II procedure code reminders
NOTE
Since ExamWRITER Administration does not have the option to create fee slips, this procedure is only
applicable to OfficeMate Administration.
1. From the OfficeMate Administration main window, click Setup.
2. Select Preferences.
The System Preferences window opens.
3. Click the Finance tab.
4. Select the Yes radio button for Display reminder for level II codes.
5. Click OK to save your preferences and close the System Preferences window.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Setting Up PQRS Codes & Preferences
 To automate PQRS coding
For more information
on setting up
automatic coding,
see the “Auto PQRS”
recorded video
tutorial.
This procedure tells you how to set up autocoding for PQRS codes. After you set up autocoding, all PQRS codes related
to procedures and observations you select in ExamWRITER automatically populate in the Diagnosis/Procedure Coding
window.
NOTE
This procedure is only applicable to OfficeMate Administration.
1. From the OfficeMate Administration main window, click Setup.
2. Select Insurance Setup.
The Insurance Billing Initial Setup window opens.
3. Select an insurance carrier from the Carrier drop-down menu.
4. Click the Preferences tab.
5. Select the Yes radio button for the Automate PQRI setting to automatically apply PQRS codes on exams in
ExamWRITER for patients who use the selected insurance carrier as their primary insurance carrier.
6. Click Save to save your changes.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Coding for
PQRS
Measures in
ExamWRITER
After setting up PQRS codes and preferences in OfficeMate Administration or ExamWRITER Administration, ExamWRITER
automatically populates the Diagnosis/Procedure Coding window with the correct codes when you record patient
information on an exam record.
In order for ExamWRITER to accurately autocode for PQRS measures, all of the correct patient information, diagnoses, and
procedures must be selected during an exam. If you are viewing an exam of a patient whose primary insurance carrier is
Medicare, then all items associated with a PQRS measure are marked with green text. Also, when you hover over an item
in most Examination, Impression, and Treatment windows, a description of the selection and all diagnosis and procedure
codes related to that selection display in the Full Description box near the top of the window.
The sections below list the requirements for the Denominator and Numerator for each measure, as well as instructions for
correctly administering an exam so that the appropriate PQRS codes are autocoded. All of the instructions assume that
PQRS autocoding has been enabled. While some PQRS measures allow you to append modifiers (1P, 2P, and 8P) to CPT
II codes, you must right-click in the Mod1 and Mod2 columns next to procedure codes and manually add these modifiers
in the Diagnosis/Procedure Coding window in ExamWRITER.
This section describes how to document the following PQRS measures on exam records in ExamWRITER:
•
Measure 12: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation, 14
•
Measure 14: Age-Related Macular Degeneration (AMD): Dilated Macular Examination, 16
•
Measure 19: Diabetic Retinopathy: Communication with the Physician Managing On-Going Diabetes Care, 19
•
Measure 117: Diabetes Mellitus: Dilated Eye Exam in Diabetic Patient, 22
•
Measure 130: Documentation of Current Medications in the Medical Record, 26
•
Measure 140: Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement, 30
•
Measure 141: Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR
Documentation of a Plan of Care, 32
•
Measure 226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention, 34
•
Measure 317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented, 36
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 12: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
Description
Percentage of patients aged 18 years and older with a diagnosis of POAG who have an optic nerve head evaluation during
one or more office visits within 12 months.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these diagnosis codes:
H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.11X0, H40.11X1, H40.11X2, H40.11X3, H40.11X4,
H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224,
H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.1290, H40.1291, H40.1292, H40.1293, H40.1294,
H40.151, H40.152, H40.153, H40.159
•
One of these exams:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242,
99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328,
99334, 99335, 99336, 99337
Numerator
Must have ONE of the following:
•
2027F
•
2027F with 1P
•
2027F with 8P
Documenting Measure 12 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Examination category bar.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
3. Select the Optic Nerve and Glaucoma check boxes, and click Process.
4. In the Optic Nerve window, select the OPTIC NERVE check box and click Process.
5. In the OPTIC NERVE window, select the appropriate check boxes for the conditions you observe, and click Process.
6. In the Glaucoma window, select the Evaluation OPTIC DISC and Impression check boxes.
7. In the OPTIC DISC EVALUATION window, select the appropriate check boxes for the conditions you observe, and
click Process.
8. In the IMPRESSION/GLAUCOMA window, select the appropriate check boxes for the conditions you observe, and
click Process.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 14: Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Description
Percentage of patients aged 50 years and older with a diagnosis of AMD who had a dilated macular examination
performed which included documentation of the presence or absence of macular thickening or hemorrhage AND the level
of macular degeneration severity during one or more office visits within 12 months.
Denominator
Must meet ALL of these requirements:
•
Patient aged 50 years or older
•
One of these diagnosis codes:
H35.30, H35.31, H35.32
•
One of these exams:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305,
99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
Numerator
Must have the following CPT II code:
•
2019F
•
2019F with 1P
•
2019F with 2P
•
2019F with 8P
Documenting Measure 14 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Examination category bar.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
3. Select the Macula check box and click Process.
4. In the Macula window, select the Examination MACULA and Impression check boxes, click Process, and
document the conditions appropriately in each window.
5. With the Exam - Special Tests tab open, click the Dilation box.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
6. In the Dilation Orders window, select the check box for the appropriate medication, type any necessary text in the
Custom Text text box, and click Save/Exit.
7. With the Exam - Special Tests tab open, click the Auto box.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 19: Diabetic Retinopathy: Communication with the Physician Managing On-Going
Diabetes Care
Description
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or
fundus exam performed with documented communication to the physician who manages the on-going care of the patient
with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these diagnosis codes:
E08.311, E08.319, E08.321, E08.329, E08.331, E08.339, E08.341, E08.349, E08.351, E08.359, E09.311, E09.319,
E09.321, E09.329, E09.331, E09.339, E09.341, E09.349, E09.351, E09.359, E10.311, E10.319, E10.321, E10.329,
E10.331, E10.339, E10.341, E10.349, E10.351, E10.359, E11.311, E11.319, E11.321, E11.329, E11.331, E11.339,
E11.341, E11.349, E11.351, E11.359, E13.311, E13.319, E13.321, E13.329, E13.331, E13.339, E13.341, E13.349,
E13.351, E13.359
•
One of these exams:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242,
99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328,
99334, 99335, 99336, 99337
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Numerator
Must have ONE of the following:
•
5010F and G8397
•
5010F with 1P and G8397
•
5010F with 2P and G8397
•
5010F with 8P and G8397
•
G8398
Documenting Measure 19 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Examination category bar.
3. Select the Retina - Vascular check box and click Process.
4. Select the RETINAL VASCULAR DISORDERS and Impression check boxes, click Process, and document the
conditions appropriately in each window.
In the IMPRESSION/RETINA - VASCULAR window, be sure to select a diagnosis and a level of severity.
5. Click the Surgery - Plan - Mgmt tab.
6. Click the Plan category bar.
7. Select the Retina - Vascular check box and click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
8. Select the Diabetes Managing Provider Report (5010F) check box and one of the following check boxes:

Document Dilation and DR & ME: Dilation performed with retinopathy and macular edema report (G8397)

Document No Dilated Exam: Dilated macular or fundus exam not performed (G8398)
9. Click Process.
10. Click the Print icon in the ExamWRITER chart window.
11. Select Auto Letter [MU, QRM] from the drop-down menu and print a letter to the patient’s primary care physician.
NOTE
The autoletter must be printed the same day as the exam.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 117: Diabetes Mellitus: Dilated Eye Exam in Diabetic Patient
Description
Percentage of patients aged 18 through 75 years with a diagnosis of diabetes mellitus who had a dilated eye exam.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18–75 years
•
One of these diagnosis codes:
E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.321, E10.329, E10.331, E10.339, E10.341, E10.349,
E10.351, E10.359, E10.36, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59,
E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.641, E10.649, E10.65, E10.69,
E10.8, E10.9, E11.00, E11.01, E11.21, E11.22, E11.29, E11.311, E11.319, E11.321, E11.329, E11.331, E11.339,
E11.341, E11.349, E11.351, E11.359, E11.36, E11.39, E11.40, E11.41, E11.42, E11.43, E11.44, E11.49, E11.51,
E11.52, E11.59, E11.610, E11.618, E11.620, E11.621, E11.622, E11.628, E11.630, E11.638, E11.641, E11.649,
E11.65, E11.69, E11.8, E11.9, E13.00, E13.01, E13.10, E13.11, E13.21, E13.22, E13.29, E13.311, E13.319, E13.321,
E13.329, E13.331, E13.339, E13.341, E13.349, E13.351, E13.359, E13.36, E13.39, E13.40, E13.41, E14.42, E13.43,
E13.44, E13.49, E13.51, E13.52, E13.59, E13.610, E13.618, E13.620, E13.621, E13.622, E13.628, E13.630, E13.638,
E13.641, E13.649, E13.65, E13.69, E13.8, E13.9, O24.011, O24.012, O24.013, O24.019, O24.02, O24.03, O24.111,
O24.112, O24.113, O24.119, O24.12, O24.13
•
One of these exams:
92002, 92004, 92012, 92014, 97802, 97803, 97804, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214,
99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335,
99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0270, G0271
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Numerator
Must have ONE of the following CPT II codes:
•
2022F
•
2022F with 8P
•
2024F
•
2024F with 8P
•
2026F
•
2026F with 8P
•
3072F
Documenting Measure 117 in ExamWRITER
This section tells you the different methods you can use to document a dilated eye exam, including how
•
To document a dilated eye exam for a diabetic patient, 23
•
To document a dilated eye exam for a diabetic patient when using special testing, 24
 To document a dilated eye exam for a diabetic patient
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Examination category bar.
3. Select the Retina - Vascular check box and click Process.
4. Select the RETINAL VASCULAR DISORDERS and Impression check boxes, and click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
5. In the RETINA - VASCULAR window, select the DFE performed (diabetic patient) check box, and click Process.
6. In the IMPRESSION/RETINA - VASCULAR window, select the appropriate check boxes for the conditions you
observe, and click Process.
 To document a dilated eye exam for a diabetic patient when using special testing
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Special Testing category bar.
3. In the Special Testing window, select one of the following check boxes:
24

Optomap - 92250

Remote Imaging, detect - 92227

Retinal photo - 92250

Retinal Screening - S9986
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
4. Click Process.
5. In the window that opens, select the appropriate check boxes for the conditions you observe and procedures you
perform, and click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 130: Documentation of Current Medications in the Medical Record
Description
Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of
current medications using all immediate resources available on the date of the encounter. This list must include ALL known
prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the
medications’ name, dosage, frequency and route of administration.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these exams:
90791, 90792, 90832, 90834, 90837, 90839, 90957, 90958, 90959, 90960, 90962, 90965, 90966, 92002, 92004,
92012, 92014, 92507, 92508, 92526, 92541, 92542, 92543, 92544, 92545, 92547, 92548, 92557, 92567, 92568,
92570, 92585, 92588, 92626, 96116, 96150, 96151, 96152, 97001, 97002, 97003, 97004, 97532, 97802, 97803,
97804, 98960, 98961, 98962, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99221, 99222,
99223, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345,
99347, 99348, 99349, 99350, 99495, 99496, G0101, G0108, G0270, G0402, G0438, G0439
Numerator
Must have ONE of the following G-codes:
26
•
G8427
•
G8428
•
G8430
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Documenting Measure 130 in ExamWRITER
This section tells you the different methods you can use to document Measure 130, including, how
•
To document medications, 27
•
To document Measure 130 if the patient is ineligible to report medications, 29
 To document medications
1. In a patient’s exam record in ExamWRITER, click the Patient Hx - ROS tab.
2. Click the Patient History category bar.
3. Select the Medications - Systemic/Ocular/Allergies [MU] check box and click Process.
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
4. In the Patient SYSTEMIC Medications and Allergies [MU] window, select one of the following radio buttons:
28

Verified Medications: G8427

Meds listed, not verified: G8428
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
 To document Measure 130 if the patient is ineligible to report medications
NOTE
A patient is ineligible if the patient refuses to state his or her medications, is in an emergency medical
situation, or is cognitively impaired.
1. In a patient’s exam record in ExamWRITER, click the Patient Hx - ROS tab.
2. Click the Patient History category bar.
3. Select the Reviewed [MU] check box and click Process.
4. Select the Patient is ineligible for medication assessment check box.
5. Click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 140: Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Description
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their
caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study
(AREDS) formulation for preventing progression of AMD.
Denominator
Must meet ALL of these requirements:
•
Patient aged 50 years or older
•
One of these diagnosis codes:
H35.30, H35.31, H35.32
•
One of these exams:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99307, 99308,
99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
Numerator
Must have ONE of the following:
•
4177F
•
4177F with 8P
Documenting Measure 140 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Exam - Special Tests tab.
2. Click the Examination category bar and document the patient’s macula.
3. Click the Surgery - Plan - Mgmt tab.
4. Click the Plan category bar.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
5. Select Macula and click Process.
6. In the Treatment Macula window, select one of the following check boxes:

AREDS - 4177F

AREDS II - 4177F

Oral Medication Nutraceutical - 4177F
7. Click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 141: Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure
(IOP) by 15% OR Documentation of a Plan of Care
Description
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) whose
glaucoma treatment has not failed (the most recent IOP was reduced by at least 15% from the pre-intervention level) OR if
the most recent IOP was not reduced by at least 15% from the pre-intervention level, a plan of care was documented within
12 months.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these diagnosis codes:
H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.11X0, H40.11X1, H40.11X2, H40.11X3, H40.11X4,
H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224,
H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.1290, H40.1291, H40.1292, H40.1293, H40.1294,
H40.151, H40.152, H40.153, H40.159
•
One of these exams:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99307, 99308,
99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
Numerator
Must have ONE of the following:
32
•
3284F
•
3285F and 0517F
•
3285F and 0517F with 8P
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Documenting Measure 141 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Surgery - Plan - Mgmt tab.
2. Click the Impressions/Assessment category bar.
3. Select Glaucoma and click Process.
4. In the Impression/Glaucoma window, select one of the following check boxes:

IOP Reduction is > 15% - 3284F

< 15% - 3285F

Oral Medication Nutraceutical - 0517F
5. Click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Description
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months
AND who received cessation counseling intervention if identified as a tobacco user.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these exams:
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90815, 90845, 90862,
92002, 92004, 92012, 92014, 96150, 96151, 96152, 97003, 97004, 99201, 99202, 99203, 99204, 99205, 99212,
99213, 99214, 99215
Numerator
Must have ONE of the following CPT II codes:
•
1036F
•
4004F
•
4004F with 1P
•
4004F with 8P
Documenting Measure 226 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, click the Patient Hx - ROS tab.
2. Click the Patient History category bar.
3. Select the Social [MU] check box and click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
4. Record the patient’s tobacco use status using the check box at the top of the Social History window or the radio
buttons in the Tobacco Use [MU] box. If the patient is a tobacco user, you must select the patient’s tobacco use and
either the Counseling Intervention Recommended or Pharmaceutical Intervention Recommended check box.
5. Click Process.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Coding for PQRS Measures in ExamWRITER
Measure 317: Preventive Care and Screening: Screening for High Blood Pressure and
Follow-Up Documented
Description
Percentage of patients aged 18 years and older seen during the reporting period who were screened for high blood
pressure AND a recommended follow-up plan is documented based on the current blood pressure (BP) reading as
indicated.
Denominator
Must meet ALL of these requirements:
•
Patient aged 18 years or older
•
One of these exams:
90791, 90792, 90832, 90834, 90837, 90839, 90845, 90880, 92002, 92004, 92012, 92014, 96118, 99201, 99202,
99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99318,
99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99340, 99341, 99342, 99343, 99344, 99345,
99347, 99348, 99349, 99350, D7140, D7210, G0101, G0402, G0438, G0439
Numerator
Must have ONE of the following CPT II codes:
•
G8783
•
G8950
•
G8784
•
G8785
•
G8952
Documenting Measure 317 in ExamWRITER
1. In a patient’s exam record in ExamWRITER, record the office visit (992xx).
2. Click the Exam - Special Tests tab.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Recording PQRS Codes on Fee Slips
3. Click the yellow Vital Signs button.
4. Click your cursor in the Blood Pressure box, record the patient’s Systolic, Diastolic, and Pulse in the Blood
Pressure/Pulse window,
5. Select one of the Blood Pressure radio buttons to autocode the correct PQRS procedure code in the exam.

Select Urgent or Emergent or Patient Refused to autocode the G9745 PQRS procedure code in the exam.

Select Active Diagnosis of Hypertension to autocode the G9744 PQRS procedure code in the exam.

If abnormal blood pressure readings are documented (>=120 or >=80) and you select Referred to Alternative/
Primary Care Provider, the G8950 PQRS procedure code will autocode in the exam. Additionally, the BP
measurements and field in the exam will be highlighted red.

If abnormal blood pressure readings are documented (>=120 or >=80) and you do not select Referred to
Alternative/Primary Care Provider, the G8952 PQRS procedure code will autocode in the exam. Additionally,
the BP measurements and field in the exam will be highlighted red.
6. Click Save/Exit.
Recording
PQRS Codes
on Fee Slips
You must record fee slips correctly in order for the appropriate procedures to be billed to the appropriate insurance
carriers.
If you selected any level II procedure codes in ExamWRITER, then these items will appear on the patient fee slip with a fee
of “$0.00.” When you use a PQRS diagnosis code on a fee slip, also include a level II procedure code. If you set up level
II procedure reminders, a warning appears to remind you to select a level II procedure code when an eligible diagnosis
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER
Recording PQRS Codes on Fee Slips
code is selected on the fee slip. For more information on setting up reminders on the fee slip, go to “To set up level II
procedure code reminders” on page 11.
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Participating in the Physician Quality Reporting System Using OfficeMate/ExamWRITER