2012 PQRS Measures Related to GI

December 09, 2011
CMS has included an IBD measures group to the 2012 Physician Quality Reporting System (PQRS). That measures group is a subset of the AGA adult IBD measures. The final CMS rules allow reporting of the IBD measures group only through a CMS qualified registry, not via claims. 
The IBD measures focus on transitioning patients to corticosteroid-sparing therapy and preventive care. The side effects of long-term corticosteroid steroid use, other immunosuppressants and anti-tumor necrosis factor agents make these patients especially vulnerable to preventable illnesses. The preventive care measures address immunizations and smoking assessment and cessation.
Individual 2012 PQRS measures related to gastroenterology include: 
  • Measure 185: Endoscopy & Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps — Avoidance of Inappropriate Use 
    Percentage of patients aged 18 years and older receiving a surveillance colonoscopy with a history of colonic polyp(s) in a previous colonoscopy, who had a follow-up interval of three or more years since their last colonoscopy documented in the colonoscopy report.
  • Measure 128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
    Percentage of patients aged 18 years and older with a calculated BMI in the past six months or during the current visit documented in the medical record AND if the most recent BMI is outside of normal parameters, a follow-up plan is documented. 

    Normal Parameters: Age 65 years and older BMI ≥ 23 and < 30; Age 18-64 years BMI ≥ 18.5 and < 25.
  • Measure 226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 
    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.
PQRS measures groups available for 2012 related to gastroenterology include:
  • Hepatitis C.
  • IBD.
  • Preventive care.
The hepatitis C measures, both as individual measures and a measures group, will continue to be available for reporting in the 2012 PQRS. It is allowable to report almost all of the hepatitis C measures via claims or a qualified registry. However, keep in mind that that these measures apply to chronic hepatitis not acute hepatitis diagnostic codes.
Review the AGA's in-depth analysis for information related to GI.
More information about the 2012 PQRS program, including reporting specifications, can be accessed at www.cms.gov/PQRS/.

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