This collection type is available for individuals, groups, and virtual groups that are small practices (fewer than 15 providers billing under the same TIN)
At the conclusion of an encounter, codes can be added to a CMS-1500 form to let Medicare know what quality actions were taken during a visit. RevolutionEHR facilitates participation in claims-based reporting through the Quality Alert on the coding screen within an encounter: See Example
The Quality Alert provides a number of, but not all, possible quality data codes for the patient based on conditions evaluated during that visit (as determined by the diagnoses appearing in Today’s Diagnoses). As an example, a patient with a primary open angle glaucoma diagnosis appearing in Today’s Diagnoses would see the two glaucoma-related measures available for claims-based reporting appear in the Alert: See Example
The provider can then check the appropriate measures, click “Add Selected” and the quality codes would appear in the encounter ready to be applied to the claim. The Quality Alert will provide codes pertaining to 7 quality measures for 2020:
- POAG: Optic Nerve Evaluation
- POAG: Reduction of IOP ≥15% OR Documentation of a Plan of Care
- AMD: Dilated Macular Evaluation
- Diabetes: Eye Exam
- Documentation of Current Medications in the Medical Record
- Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention
- Preventative Care and Screening: Screening for High Blood Pressure and Follow Up Documented
Removed by CMS for 2020: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care, Pain Assessment and Follow Up
* measure in blue is an “outcome” measure (2 bonus points if reported successfully). Measures in green are non-outcome “high priority” measures (1 bonus point if reported successfully).
** the 4 eye-specific measures will appear in the alert as pertinent to the case. The 3 diagnosis-independent measures will appear for each encounter without regard to diagnoses.
Alternate measures that a provider might choose to report through the course of the year should be added to the Common Services list for easy addition to a claim as pertinent. Remember that the goal is to report on 6 measures more than 70% of the time that they apply throughout the year. Thus, providers should identify which codes fit their practice and patient base, make sure they’re available to be added to claims either through the Quality Alert or the Common Services list and develop consistency in reporting them.