PQRS Individual Measures Data Entry Guide The deadline t submit PQRS data t New Jersey Innvatin Institute fr prgram year 2016 is March 10 th, 2017
Purpse f this Guide This guide prvides simple, step-by-step instructins t help Eligible Prfessinals (EPs) satisfy Physician Quality Reprting System (PQRS) requirements fr the 2016 prgram year using NJII s Qualified PQRS registry. This guide is intended fr EPs wh are reprting using a Measures Grup. If yu are reprting using Individual Measures, please see the PQRS Individual Measure Data Entry Guide. Cntents Overview Individual Measures PQRS Requirements Hw t Get Started with NJII s Qualified Registry Step-by-Step Data Entry Guide Lg In Prepare Yur PQRS Data Enter Yur Data Review Yur PQRS Summary Cmplete Yur Final Submissin
Overview Individual Measures With NJII yu can mix and match frm 198 Individual Measures t reprt n the best measures that represent the prvider the best, allwing mre flexibility fr measure selectin. Individual Measures must be reprted fr Medicare Part B Fee-Fr-Service (FFS) patients seen by an Eligible Prfessinal (EP) thrughut the full calendar year. EPs must reprt n at least 9 measures cvering at least 3 Natinal Quality Strategy (NQS) dmains fr >50% f Medicare Part B FFS patients eligible fr each measure. The Measures Applicability Validatin (MAV) Reprting a Measures Grup is a simple ptin fr many reasns: T avid the -2% penalty in 2017, EPs must: Reprt at least 9 individual measures acrss at least 3 dmains Reprt n at least 50% f eligible Medicare Part B FFS patients r encunters fr each measure Reprt ne (1) crss-cutting measure if they had at least ne (1) face-t-face encunter with a Medicare fee-fr-service patient during 2016 Fr each measure, reprt a perfrmance f greater than 0% (r less than 100% fr inverse measures, where a lwer perfrmance rate indicates better perfrmance) List f 2016 Crss Cutting Measures: #1 Diabetes: Hemglbin A1c Pr Cntrl #46 Medicatin Recnciliatin Pst Discharge #47 Care Plan #110 Preventive Care and Screening: Influenza Immunizatin #111 Pneumnia Vaccinatin Status fr Older Adults #112 Breast Cancer Screening #128 Preventive Care and Screening: Bdy Mass Index (BMI) Screening and Fllw-Up Plan #130 Dcumentatin f Current Medicatins in the Medical Recrd #131 Pain Assessment and Fllw Up #134 Preventive Care and Screening: Screening fr Clinical Depressin and Fllw-Up Plan #154 Falls: Risk Assessment #155 Falls: Plan f Care #182 Functinal Outcme Assessment #226 Preventive Care and Screening: Tbacc Use: Screening and Cessatin Interventin #236 Cntrlling High Bld Pressure #317 Preventive Care and Screening: Screening fr High Bld Pressure and Fllw-Up Dcumented #400 One-Time Screening fr Hepatitis C Virus (HCV) fr Patients at Risk: #402 Tbacc Use and Help with Quitting Amng Adlescents #431 Preventive Care and Screening: Unhealthy Alchl Use: Screening & Brief Cunseling
PQRS Requirements T satisfy prgram year 2016 PQRS requirements fr reprting Individual Measures and avid a 2% payment adjustment in 2018: 1. Chse 9 Measures Grup acrss at least 3 f the NQS Dmains that is relevant t yur EP. Review the perfrmance numeratr criteria fr each measure t make sure the measures are relevant t yur scpe f practice. TIP: CMS specificatins fr each Measures can be fund n the NJII Prtal. On the Getting Started Tab, click the Reprting Individual Measures sub tab, and then click n the link fr the Specificatin Manual. 2. Cllect the ttal number f Eligible Instances per Individual Measure the prvider is reprting n. Make sure the patients are Medicare FFS patients (includes Medicare Secndary and Railrad Medicare). T identify eligible patients, search fr claims with dates f service during 2015 that have specific patient denminatr criteria such as diagnsis, age, and prcedure (CPT) cde. Mst electrnic billing sftware and/r vendrs will be able t generate a reprt f eligible patients using these criteria. TIP: Use the CMS Specificatin Sheets n the NJII Prtal t review denminatr criteria. On the Getting Started Tab, click the Reprting Individual Measures sub tab, and then click n the link fr the Specificatin Manual. 3. Cllect data fr each individual measure the prvider is reprting. The clinical data related t the measures can be dcumented in either paper, electrnic charts, r reprts but prf that the reprted clinical actin was perfrmed must be clearly dcumented in the patient s recrds. Make sure that yu can supply this supprting dcumentatin t CMS in the event f an audit. Cllect the fllwing summary r aggregate data required t reprt individual measures: # f Eligible Instances # f Eligible Instances where perfrmance is met # f Eligible Instances where perfrmance is excluded # f Eligible Instances where perfrmance is nt met 4. Submit data t NJII s Qualified PQRS Registry by March 10, 2017. Hw t Get Started with NJII s Qualified Registry If yu have nt yet registered fr prgram year 2016, please cntact a NJII PQRS Specialist at 973-642-4055 r pqrs@njii.cm.
Step-by-Step Data Entry Guide Step 1: Lg In Users will receive their username and passwrd (in tw separate emails) immediately after payment has been received by NJII. NOTE: If yu have previusly used NJII s PQRS Registry (Frmerly NJ-HITEC) fr reprting, yu will receive a new username and passwrd fr 2016 Reprting Visit http://www.mynjii.cm/pqrs in a new brwser windw Lg in with yur mynjii Prtal username and passwrd If yu frgt yur passwrd r yur passwrd is incrrect, click n Frgt Passwrd t reset it Yu can skip t Step 3 if yu have already cllected yur patient data Step 2: Prepare Yur PQRS Data Click Reprting Individual Measures in the tp menu t view 2016 PQRS reprting requirements and dwnlad CMS Individual Measures Specificatin Sheets. Use the Reprting Criteria n CMS Individual Measures Specificatins Manual t cllect data fr at least 9 measures acrss 3 Natinal Quality Strategy (NQS) Dmains. Cllect the fllwing summary r aggregate data required t reprt Individual Measures: # f Eligible Instances # f Eligible Instances where perfrmance is met # f Eligible Instances where perfrmance is excluded # f Eligible Instances where perfrmance is nt met
Step 3: Enter Yur Data Step 3A: Select Individual Measures Click the Data Entry tab Select a prvider by clicking n the crrespnding rw in the table displayed n the screen Verify that the prvider s NPI and Tax ID are crrect Click under the Reprting Type clumn A Reprting Type pp-up windw will appear Select Individual Measures and click Save Scrll t the bttm f the page and click Enter Data in the lwer right hand crner
Step 3B: Select Yur Reprting Gal and Measures T begin selecting yur Individual Measures answer the 2 questins belw: Has this prvider had at least 1 face-t-face encunter with a Medicare patient during 2016? D at least 9 measures acrss 3 NQS dmains apply t this prvider? Click Add Measures in the tp right crner T add a Measure t yur Measures List click check bx t the left f the Measure # T add r remve a Favrite measure, click the star in the Favrites clumn Once yu have all yur Measures Selected, Click Save at the tp f the screen Fr inverse measures, a lwer perfrmance % is better (Inverse Measures are indicated by Hver ver clumn header title fr mre details Step 3C: Reprt Yur Measures Enter in the data cllected fr each measure # f Eligible Instances # f Eligible Instances where perfrmance is met # f Eligible Instances where perfrmance is excluded # f Eligible Instances where perfrmance is nt met
Step 4: Review Yur PQRS Data On the Data Entry screen: Review yur PQRS Measures List t make sure all applicable measures are reprted. If a measure is incmplete enter in the missing fields Click Submit in the tp right t prceed t the final submissin screen The PQRS Measures List breaks dwn the reprting rate and perfrmance rate based n CMS guidelines. The reprting rate is the percentage f eligible patients fr whm yu selected a perfrmance. The perfrmance rate is the number f eligible patients that meet the measure criteria. Yu need t have a 50% reprting rate t meet the PQRS requirements, and shuld aim fr a high-perfrmance rate t indicate better quality care. The items n the Submissin Checklist (at the bttm f the screen) represent the minimum requirements t avid the 2018 PQRS payment adjustment f -2%. Yu must meet all gals t successfully submit yur PQRS data t NJII s Registry. The Submit buttn will nly be active when all criteria in the Submissin Checklist are met.
Step 5: Cmplete Yur Final Submissin Duble-check yur NPI and Tax ID! If yur NPI and/r Tax ID is incrrect, DO NOT PROCEED with yur submissin. Call NJII at 973-642-4055 t update yur NPI and/r Tax ID infrmatin. Check the bx next t each statement t agree Cmplete the Submitter Validatin fields Once yu have duble-checked yur infrmatin, click Submit The deadline t submit PQRS data t New Jersey Innvatin Institute fr prgram year 2016 is March 10 th, 2017