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Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: [email protected] web: thecodingeducator.com

Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

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Page 1: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Surviving the Value Modifier, PQRS & MIPScpt, pqrs, value modifier and icd-10

Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA

email: [email protected] web: thecodingeducator.com

Page 2: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

www.thecodingeducator.com

Page 3: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Discussion Points

• Physician Compare• Value Modifier • Quality, Cost, Experience• ICD-10 & Risk Adjustment• PQRS • QRUR• CCM and TCM

Page 4: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Physician Compare

Page 5: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 6: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Value Based Modifier

Page 7: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Value ModifierBy now you are probably aware that there is a big push to move away from paying for care on a "fee-for-service" basis and toward paying for value and quality of care instead. To ensure that the market could move toward value more effectively, the Affordable Care Act required Medicare to establish a "value modifier (VM)" that provides for differential payment to providers based upon the quality of care furnished to Medicare beneficiaries compared to the cost of that care during a performance period. -

Page 8: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Value Added Modifier

Page 9: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Quality

Page 10: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Value Modifier Reduction

Page 11: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Additive

Page 12: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Costs

Page 13: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Experience

Page 14: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Risk

Page 15: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

ICD-10 and Risk Adjustment

Page 16: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

SOURCE: Chronic Condition Data Warehouse (CCW). Medicare Beneficiary Summary Files.

Page 17: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Anemia

Page 18: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

DM

Page 19: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

DM

Page 20: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

HPL

Page 21: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

HTN

Page 22: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

HF

Page 23: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 24: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Hyperlipidemia

Page 25: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Long Term Use

Page 26: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Non Compliance

Page 27: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 28: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 29: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 30: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Tools for ICD-10

Page 31: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

National Center for Health Statistics

Page 32: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 33: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 34: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 35: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Chapters

Page 36: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Internet

Page 37: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 38: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

IPhone

Page 39: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

I-phone/Android Application

Page 40: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Intelligent Medical Object(IMO)

Page 41: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 42: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 43: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 44: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 45: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 46: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 47: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 48: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 49: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 50: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

SOURCE: Chronic Condition Data Warehouse (CCW). Medicare Beneficiary Summary Files.

Page 51: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

PQRS for Dummies

Page 52: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

What is PQRS• The Physician Quality Reporting System (PQRS) is a

reporting program that uses a combination of incentive payments and payment adjustments (penalties) to promote reporting of quality information. Although PQRS is a standalone "pay for reporting" program, it drives other CMS programs that require quality reporting that are "pay for performance," including the Value-Based Payment Modifier Program.

Page 53: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 54: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

PQRS Registry

Page 55: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Specialty Measure Setshttp://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQ

RS/MeasuresCodes.html

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html
Page 56: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 57: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 58: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 59: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

QRUR – Final Score

Page 60: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

QRUR • Information on performance is provided to

participants in the form of Physician Quality & Resource Use Reports (QRURs). These reports are used to monitor the potential value modifier adjustment, and to improve performance.

Page 61: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 62: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

What Do I Do?

Page 63: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

What Do I Do?

Page 64: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Merit Based Payment

Page 65: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

2018 End of PQRS Reductions – Not So Fast –

Page 66: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 67: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 68: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

2019 - MIPS

Page 69: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 70: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 71: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps
Page 72: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

SOURCE: Chronic Condition Data Warehouse (CCW). Medicare Beneficiary Summary Files.

Page 73: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Discussion Points

• Physician Compare• Value Modifier • Quality, Cost, Experience• ICD-10 & Risk Adjustment• PQRS • QRUR• CCM and TCM

Page 74: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Questions?

Page 75: Steve Adams,...Surviving the Value Modifier, PQRS & MIPS cpt, pqrs, value modifier and icd-10 Steve Adams, MCS, COC, CPC, CPMA, CPC-I, PCS, FCS, COA email: steve.adams@inhealthps

Any QuestionsDirect: 706-483-4728

E-Fax: 770-709-3698

E-mail: [email protected]

Web: www.thecodingeducator.com

Facebook: facebook.com/kingofcoders


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