Payment and Reimbursement

Physician Quality Reporting Initiative (PQRI) Information

For complete information and to view an updated list of frequently asked questions, visit the Centers for Medicare & Medicaid Services (CMS) PQRI Web site.

AUA Resources

2010 PQRI Specifications for Urologist

      Measure Specifications:

• Perioperative Care: Timing of Antibiotic Prophylaxis
• Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
• Medication Reconciliation Specifications
• Urinary Incontinence Specifications
• Prostate Cancer Specifications
• Tobacco Use Specifications
• Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)

      Measure Flowcharts:

         Perioperative Measures

• Measure #20: Perioperative Care: Timing of Antibiotic Prophylaxis
• Measure #23: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)

         Medication Reconciliation

• Measure #46: Medication Reconciliation Specifications

         Urinary Incontinence

• Measure #48: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
• Measure #49: Urinary Incontinence: Characterization of Urinary Incontinence in Women Aged 65 Years and Older
• Measure #50: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

         Prostate Cancer

• Measure #102: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low-Risk Prostate Cancer Patients
• Measure #104: Prostate Cancer: Adjuvant Hormonal Therapy for High-Risk Prostate Cancer Patients
• Measure #105: Prostate Cancer: Three-Dimensional (3D) Radiotherapy

         Tobacco Use

• Measure #114: Preventive Care and Screening: Inquiry Regarding Tobacco Use
• Measure #115: Preventive Care and Screening: Advising Smokers and Tobacco Users to Quit

         Health Information Technology

• Measure # 124: Health information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)

     Helpful tools for PQRI:

• AUA Mastering the Basics of PQRI CD
• PQRI Registry Provider information chart
• Sample order forms and questionnaires
     - Physician Orders and Incontinence Measure Worksheet
     - Generic Medicare PQRI Quality Code Reporting for Urinary Incontinence
     - Generic Urinary Incontinence Care Plan
     - Generic Urinary Incontinence Assessment Sheet
     - PQRI Incontinence Survey
  
• Sample CMS 1500 Forms
• Frequently Asked Questions

Click here to view 2009 Specifications.

Click here to view 2008 Specifications

CMS Resources

• Glossary of Terms
• 2010 Sample Measures Specification Document
• CMS 1500 Claim

American Medical Association (AMA) Resources

• AMA PQRI 2010 Information (data collection sheets, descriptions, specifications)

American College of Surgeons (ACS) Resources (all surgical measures)