Penalties waived in wake of ICD coding error
The mix-up could have led to applied physician penalties under the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier program. The mix-up occurred after a delayed transition to ICD-10-CM, which was considered a larger update than normal and was not finalized until two months before the update was released.
The PQRS was not updated to include the new codes.
As a result of these two incidences, the AMA was worried about the impact on physicians. Officials worked with CMS so eligible physicians and group practices would not be penalized. CMS will analyze and review submissions of quality measures for the 2016 PQRS when the 2016 PQRS reporting period closes.
The most impacted coding changes included quality measures related to diabetes, pregnancy, cardiology, oncology, mental health and eye diseases.
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