Things to note about 2016 PQRS:
- The minimum reporting level for 2016 remains 9 measures covering at least 3 domains of care. Also, at least one of the 9 measures must be a cross-cutting measure.
- To satisfactorily report a measure, you must report on at least 50 percent of the Medicare Part B patients that are applicable to that measure.
- Participants may also report using a measure group. If this is selected, users must report each measure in the group for a minimum of 20 patients (a majority of whom must be Medicare Part B patients).
- CMS continues to offer reporting options for individuals and group reporting. If you select group reporting, you must have registered with CMS as a group by June 30, 2016.
- The data reported in 2016 will be used to assess the 2018 payment adjustment for incorrectly or not reporting. The penalty will be -2 percent.
Email AUA with questions at PQRS@auanet.org.
AUA Resources
Measures
- 2016 Individual measures recommended by the AUA [pdf]
- 2016 Individual measures recommended for urology by CMS
- 2016 Cross cutting measures
- CMS Measure Information
Reporting Options
Measure Specifications
- Measure# 23 – Perioperative Care, Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) [pdf]
- Measure# 46 – Medication Reconciliation [pdf]
- Measure# 47 – Advance Care Plan [pdf]
- Measure# 48 – Urinary Incontinence, Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 50 – Urinary Incontinence, Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 102 – Prostate Cancer, Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients [pdf]
- Measure# 104 – Prostate Cancer, Adjuvant Hormonal Therapy for High Risk Prostate Cancer Patients [pdf]
- Measure# 110 – Preventive Care and Screening, Influenza Immunization [pdf]
- Measure# 113 – Colorectal Cancer Screening [pdf]
- Measure# 119 – Diabetes, Medical Attention for Nephropathy [pdf]
- Measure# 121 – Adult Kidney Disease: Laboratory Testing [pdf]
- Measure# 122 – Adult Kidney Disease: Blood Pressure Management [pdf]
- Measure# 128 – Preventive Care and Screening, Body Mass Index (BMI) Screening and Follow-Up [pdf]
- Measure# 130 – Documentation of Current Medications in the Medical Record [pdf]
- Measure# 131 – Pain Assessment and Follow-Up [pdf]
- Measure# 143 – Oncology: Medical and Radiation - Pain Intensity Quantified [pdf]
- Measure# 144 – Oncology: Medical and Radiation - Plan of Care for Pain [pdf]
- Measure# 145 – Radiology: Exposure Time Reported for Procedures Using Fluoroscopy [pdf]
- Measure# 226 – Preventive Care and Screening, Tobacco Use, Screening and Cessation Intervention [pdf]
- Measure# 236 – Controlling High Blood Pressure [pdf]
- Measure # 238 – Use of High-Risk Medications in the Elderly [pdf]
- Measure# 265 – Biopsy Follow-Up [pdf]
- Measure# 317 – Preventive Care and Screening, Screening for High Blood Pressure and Follow-Up Documented [pdf]
- Measure# 358 – Patient-centered Surgical Risk Assessment and Communication [pdf]
- Measure# 408 - Opioid Therapy Follow-up Evaluation [pdf]
- Measure# 412 – Documentation of Signed Opioid Treatment Agreement [pdf]
- Measure# 414 – Evaluation or Interview for Risk of Opioid Misuse [pdf]
- Measure# 422 – Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury [pdf]
- Measure# 428 – Pelvic Organ Prolapse: Preoperative Assessment of Occult Stress Urinary Incontinence [pdf]
- Measure# 429 - Pelvic Organ Prolapse: Preoperative Screening for Uterine Malignancy [pdf]
- Measure# 431 – Preventive Care and Screening, Unhealthy Alcohol Use: Screening & Brief Counseling [pdf]
- Measure# 432 – Proportion of Patients Sustaining a Bladder Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 433 – Proportion of Patients Sustaining a Major Viscus Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 434 – Proportion of Patients Sustaining a Ureter Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 436 – Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques [pdf]
Measure Flowcharts
- Measure# 23 – Perioperative Care, Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) [pdf]
- Measure# 46 – Medication Reconciliation
- Measure# 47 – Advance Care Plan [pdf]
- Measure# 48 – Urinary Incontinence, Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 50 – Urinary Incontinence, Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 102 – Prostate Cancer, Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients [pdf]
- Measure# 104 – Prostate Cancer, Adjuvant Hormonal Therapy for High Risk Prostate Cancer Patients [pdf]
- Measure# 110 – Preventive Care and Screening, Influenza Immunization [pdf]
- Measure# 113 – Colorectal Cancer Screening [pdf]
- Measure# 119 – Diabetes, Medical Attention for Nephropathy [pdf]
- Measure# 121 – Adult Kidney Disease: Laboratory Testing [pdf]
- Measure# 122 – Adult Kidney Disease: Blood Pressure Management [pdf]
- Measure# 128 – Preventive Care and Screening, Body Mass Index (BMI) Screening and Follow-Up [pdf]
- Measure# 130 – Documentation of Current Medications in the Medical Record [pdf]
- Measure# 131 – Pain Assessment and Follow-Up [pdf]
- Measure# 143 – Oncology: Medical and Radiation - Pain Intensity Quantified [pdf]
- Measure# 144 – Oncology: Medical and Radiation - Plan of Care for Pain [pdf]
- Measure# 145 – Radiology: Exposure Time Reported for Procedures Using Fluoroscopy [pdf]
- Measure# 226 – Preventive Care and Screening, Tobacco Use, Screening and Cessation Intervention [pdf]
- Measure# 236 – Controlling High Blood Pressure [pdf]
- Measure # 238 – Use of High-Risk Medications in the Elderly [pdf]
- Measure# 265 – Biopsy Follow-Up [pdf]
- Measure# 317 – Preventive Care and Screening, Screening for High Blood Pressure and Follow-Up Documented [pdf]
- Measure# 358 – Patient-centered Surgical Risk Assessment and Communication [pdf]
- Measure# 408 - Opioid Therapy Follow-up Evaluation [pdf]
- Measure# 412 – Documentation of Signed Opioid Treatment Agreement [pdf]
- Measure# 414 – Evaluation or Interview for Risk of Opioid Misuse [pdf]
- Measure# 422 – Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury [pdf]
- Measure# 428 – Pelvic Organ Prolapse: Preoperative Assessment of Occult Stress Urinary Incontinence [pdf]
- Measure# 429 - Pelvic Organ Prolapse: Preoperative Screening for Uterine Malignancy [pdf]
- Measure# 431 – Preventive Care and Screening, Unhealthy Alcohol Use: Screening & Brief Counseling [pdf]
- Measure# 432 – Proportion of Patients Sustaining a Bladder Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 433 – Proportion of Patients Sustaining a Major Viscus Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 434 – Proportion of Patients Sustaining a Ureter Injury at the Time of any Pelvic Organ Prolapse Repair [pdf]
- Measure# 436 – Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques [pdf]
Helpful tools for PQRS
Sample Order Forms and Questionnaires
- Physician Orders and Incontinence Measure Worksheet [pdf]
- Generic Medicare PQRS Quality Code Reporting for Urinary Incontinence [pdf]
- Generic Urinary Incontinence Care Plan [pdf]
- Generic Urinary Incontinence Assessment Sheet [pdf]
- PQRS Incontinence Survey [pdf]
- Worksheet for Measure #46 – Medication Reconciliation [pdf]
- Worksheet for Measure #47 – Care Plan [pdf]
- Worksheet for Measure #110 – Preventive Care and Screening: Influenza Immunization [pdf]
- Worksheet for Measure #130 – Documentation of Current Medications in the Medical Record [pdf]
Other Resources
CMS
CMS 1500 Claim [pdf]
CMS QualityNet Help Desk
Phone: 866-288-8912
Email: QNetsupport@hcquis.org
American College of Surgeons (ACS)
Surgeon's Guide to Understanding the Physician Quality Reporting System
Physician Quality Reporting System
PQRS Reporting in 2016 and What the College is Doing to Help
PQRS 2016 Options through the Surgeon Specific Registry (SSR)