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PQRS Program Update – Measure #235 Claims Error

Information from PQRS email:

CMS has recently identified an error related to the submission of Measure #235, “Hypertension: Plan of Care,” for the 2012 Physician Quality Reporting System.  “Hypertension: Plan of Care” is a claims/registry measure with G-codes that are inactive due to an error found on the HCPCS tape.  Consequently, this has resulted in claims containing the G-codes associated with the measure being rejected by the carrier/MACs or denied.

 

The codes G8675, G8676, G8677, G8678, G8679, G8680, and 4050F will be reactivated with the next update of the HCPCS tape in April 2012.  For 2012 claims-based reporting, PQRS requires at least 3 measures to each be reported at a 50% reporting rate.  In the interim, eligible professionals who had intended to report this measure via claims for the 2012 PQRS may want to consider taking the following steps:

  • Eligible professionals may want to consider reporting additional measures to substitute for Measure #235, “Hypertension: Plan of Care.”
  • “Hypertension: Plan of Care” is a per-visit measure, which requires reporting for 50% of eligible patient visits.  Therefore, eligible professionals could report the measure on more than 50% of eligible visits from April through December 2012 to increase the likelihood for successful reporting of the measure.

 

For additional information, visit the Physician Quality Reporting System webpage on the CMS website.