• PQRS FAQs


    The following are frequently asked questions submitted to pqrs@aao.org.

    Question: I noticed that the Cataracts Measures Group only has 8 measures. Will we need to add another measure for reporting in 2015 in order to meet the requirement for 9 measures?

    Answer: Successfully reporting the Cataracts Measures Group is sufficient to avoid the penalty. You do not need to add a 9th measure.

    Question: We have an ophthalmologist and an optometrist in our practice and have been considering the Cataracts Measures Group. Is the optometrist able to submit any of these group measures?

    Answer: Only cataract surgeons can report the Cataracts Measures Group. Optometrists should select another method to successfully report.

    Question: Is it possible to submit some measures by IRIS registry and some by claims to try to get to 9?

    Answer: Unfortunately not. Successful reporting is accomplished via claims, registry or EHR reporting, but not a combination.

    Question: If a patient has cataract surgery bilaterally during the reporting period of 2015, can both surgeries be reported separately and count as two for the cataracts measures group?

    Answer: If the surgeries are performed on different days, they can both be included. Both surgeries will need their own surveys submitted. 

    Question: Does IRIS send out the survey/questionnaires for patient satisfaction and visual improvement measures for the cataracts measures group? Are these two different questionnaires? What if the patients don’t respond?

    Answer: IRIS provides the practice with the surveys and return envelopes. The practice will then issue the surveys to the chosen patients. There’s a preop VF-8R survey, a postop VF-8R, and a postop Surgical Care Survey. As long as you’ve administer the surveys, you’ll get credit for measures 303 and 304.

    You select the patients. They do not have to be consecutive. 

    You will report the measures within a web portal the IRIS Registry will provide. IRIS has record of the patients and will contact them if the surveys are not returned.

    Question: Since Measure 18 can only be reported via EHR, can we report it by EHR and submit the other 8 via a registry?

    Answer: Only one method of reporting will qualify, not a combination of two.

    Question: When entering information into IRIS Registry, our three measures show up. Can I leave the measures that do not apply to this date of service blank or should I input information?

    Answer: According to IRIS Registry staff, you can leave the non-applicable measures blank and report on the measures that apply.

    Question: Measure 317 pertaining to blood pressure is not suggested on the AAOE site. Is this a measure ophthalmologists should be reporting?

    Answer: The issue with measure 317 is that the ophthalmologist would have to document a follow- up plan if the patient has a high BP reading. The Academy feels the ophthalmologist is not responsible for the plan of action and ensuring the control of BP. However, if it fits your practice, you may go ahead and report the measure.

    Question: The Cataracts Measures Group requires two cross-cutting measures be reported, (i.e., measures 130 Documentation of medication and 226 Smoking cessation).  Are we to report on only the 20 cataract patients or do we need to report on all our Medicare Part B patients?

    Answer: You only need to report on your 20 surgical patients.

    Question: Pertaining to the Cataracts Measures Group: What if the twenty patients chosen do not have any complications pertaining to Measures 192, 388 and 389? Will we need to report additional measures?

    Answer: The measures will still count even without complications. Review each measure for the appropriate modifier or code to submit.

    Question: If we were to add a new physician to our practice in August or September of 2015, how would they meet the requirements?

    Answer: Start reporting PQRS the day they begin in your office.

    Question: We notice that measure 1 Diabetes HbA1c poor control is not listed as one of the cross-cutting measures.  Is this measure not available via claims reporting for ophthalmologists?

    Answer: Ophthalmologists aren't really responsible for this quality action; however, it’s good if they ask about HbA1c levels and reinforce strict control for overall health as well as ophthalmological complications. Since an ophthalmologist is not really responsible for maintaining good control of HgA1c nor do they themselves usually check the level of HgA1c, it is not a recommended measure.

    Question: I am unclear on the Medicare Part B patients for PQRS submission. What if we do not have patients with this type of insurance?

    Answer: PQRS applies to Medicare Part B, Medicare as a Secondary Payer, and Railroad Medicare patients. Depending on your contract with Medicare Advantage Plans, it could include those patients as well. All details can be found at www.aao.org/pqrs

    Question: Why does AAOE include measures referring to cutaneous melanoma (137, 228, and 224)? These do not pertain to choroidal melanoma?

    Answer: We have included these measures since Oculofacial surgeons can see and treat these patients, or refer for treatment. These measures are the only ones available to them.

    Question: What if practices try to participate in PQRS, but fail to do it successfully; is failure to participate successfully the same as failure to participate at all? Does this result in the 2% cut for VBM as well as 2% cut of PQRS?

    Answer: Yes. Unfortunately, unsuccessful reporting will result in the penalty just as non-reporting will also.

    Question: We have not been reporting on patients with Medicare as a Secondary Payer. Should we be?

    Answer: Yes. Medicare as a Secondary Payer is part of the PQRS program/penalty.