Haven’t Started MACRA QPP Prep? There’s Still Time!

Groundhog Day MACRA prep

Groundhog Day has come and gone, and Punxsutawney Phil has declared six more weeks of winter. That gives you plenty of inside time to focus on getting up to speed on MACRA so you can participate in 2017.

Remember: With CMS’s Pick Your Pace approach to the Merit-based Incentive Payment System (MIPS), it’s OK if you weren’t ready to hit the ground running on January 1. Submitting Quality Payment Program (QPP) data for the full year offers your best chance for a bonus, but even a little effort will go a long way to help you avoid a penalty. With that in mind, let’s take a look at QPP quality measures.

Narrow Your 270 Options Fast

CMS offers a QPP quality measures page with a tool that helps you search the 270 measures for the ones that apply to you. You can filter based on high or low priority, data submission method (such as claims or registry), and specialty measure set (your physician’s specialty).

For example, if you filter to see the high priority measures for orthopedics, here are some of the measures you’ll find in the results that are most likely to apply to your orthopedic practice:

  • Documentation of Current Medications in the Medical Record
  • Functional Status Assessment for Total Hip Replacement
  • Functional Status Assessment for Total Knee Replacement
  • Osteoarthritis (OA): Function and Pain Assessment
  • Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report
  • Total Knee Replacement: Preoperative Antibiotic Infusion with Proximal Tourniquet
  • Total Knee Replacement: Shared Decision Making: Trial of Conservative (Non-surgical) Therapy
  • Total Knee Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation
  • Use of Imaging Studies for Low Back Pain.

As a warning on the page states, the tool is just for information, so don’t assume the information in your search results is accurate. Confirm the measure requirements in the official documents. You can find Quality Measures Specifications and Quality Measures Specifications Supporting Documents on the QPP education page.

What Do Quality Measures Look Like?

The Quality part of MIPS replaces the Physician Quality Reporting System (PQRS), so you may (or may not) be pleased to know the formatting of the measures will look familiar. That means all that time you spent learning about denominators (the population evaluated) and numerators (the patients within that population who met measure requirements) won’t go to waste.

In the Quality Measures Specifications files on the QPP education page (linked in the previous section), also watch for a flow chart, written instructions, and sample calculations with the measure to help guide you through the process.

How About You?

What has helped you learn about MACRA? Do you plan to submit data for the full year?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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