ASCRS Advocacy Prompts CMS to Release Additional Information Related to ICD-10 Code Change Impact on 2016 PQRS; CMS Urges Physicians to Report as Much Data as Possible

This afternoon, CMS released additional information regarding how the agency will determine if physicians whose 2016 PQRS reporting is impacted by the updates to ICD-10 codes will receive a penalty. As we reported previously, CMS announced in December that any physician who does not successfully meet PQRS solely due to the code updates that went into effect October 1, 2016 will not be penalized.

Following advocacy from ASCRS•ASOA, CMS today released FAQs addressing this issue. The FAQ document notes that physicians should continue to report as much quality data as they are able, and that CMS will perform analyses after the submission deadline to determine if the code update was the sole factor preventing a successful completion of PQRS requirements. For physicians who report measures groups, such as Cataract or Diabetic Retinopathy, and did not meet the 20 patient threshold, CMS also recommends submitting the measures, even if not for the full 20 patients.

The FAQ document also indicates that CMS is assessing the possibility of notifying physicians and practices after the submission deadline whether or not they will avoid the penalty. We will keep you updated.

If you have questions, please contact Allison Madson, manager of regulatory affairs, at amadson@ascrs.org or 703-591-2220.