We are really struggling with the Physician Quality Reporting System (PQRS) codes. Our Medicare remittance is telling us 3016F is not a reportable code, but I have called and verified the code is billable. I also understand that we need to be reporting nine measures across three categories. Can you help clarify this?
Your question does not have a simple answer. We will try to break down the parts of the question into a few separate answers.
Also by the Painters - ICD-10 phase II: What you should be doing now
The first part of your question, in relation to code 3016F not being a reportable code, is confusing. In fact, 3016F is a valid code and can be used as part of reporting measure 173. However, based on your question, we can safely assume that you submitted this code on a claim. Measure 173 is not eligible for claims-based reporting but can only be reported via a registry. Therefore, the claim processing system will reject the code as it cannot be processed. The rejection notice is not very descriptive.
If you look under the PQRS measure section on the AUA Coding Today website (www.auacodingtoday.com), you can find all measures. Each measure will list in the body of the measure what methods are acceptable for reporting.
Have you read: Is modifier –22 an option for multiple stones?
Regarding the second part of your question: You are required to report at least nine individual measures across three National Quality Strategy domains, one of which must be a cross-cutting measure, or a single measures group. The issue we have seen with measures groups for urology is a lack of a measures group that truly fits the specialty. It can be done, but you will have to collect some information that is likely not in your process.