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PQRI Coding Tool Instructions

This Word document is a coding tool for reporting the appropriate PQRI quality measures. The front side lists 7 PQRI quality measures that ACP identified as being particularly relevant to internal medicine, as well as practical to collect. The back of the document lists the full definition of each of the 7 measures and describes the eligible patient population for each measure. To use this tool, follow these instructions:

1. Print (or copy) this Word document (double-sided)
2. Place these forms in patient examination rooms or, if you are a paper-based practice, attach a blank form to the chart of each Medicare beneficiary you are scheduled to see on a particular day.
3. When a patient has a clinical condition for which you have chosen to report a PQRI measure:
   1. Put the patient’s name and record number in the appropriate area on the upper right corner of the form
   2. Circle the appropriate code (and modifier if appropriate) for the measure(s) for which you are reporting
      1. Refer to the back of the form for additional guidance on the measure definition and eligible patient population
   3. Submit this form to your billing staff for reporting of the codes on your claim form

Feel free to modify this form to suit the needs of your office and staff.

Click here to download PQRI Coding Tool.

Page updated: 12/21/07

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