Frequently Asked Questions

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FAQ

Can eligible professionals participating in the Physician Quality Reporting System (PQRS) report measures for services provided as part of the global surgical package?

If a patient has an allowable Medicare Physician Fee Schedule (MPFS) Part B covered professional service, that meets the denominator criteria for the quality measure(s) being reported for PQRS, then the physician should submit the appropriate quality-data code (CPT Category II and/or G-code) on the claim (or report using applicable reporting mechanism). If the codes the physician intends to use are not present in the denominator of the measure, they may not be used for reporting and will not be counted in analysis for payment adjustment purposes.

Please refer to posted detailed measure specifications to determine if the patient encounter code(s) being submitted meets the denominator criteria for the quality measure(s) being reported. Measure specifications for PQRS can be found on the respective historical PQRS program year webpages. Please refer to your Medicare Administrative Contractor (MAC) for more information regarding Medicare claims processing and the global surgical period.

For additional questions, please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or via email to Qnetsupport@hcqis.org. They are available from 7:00 a.m. to 7:00 p.m. Central Time Monday through Friday.

(FAQ2527)

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