Audiology PQRI Reporting & Bundled Codes

Question

Answer

Dr. Fifer: Let me start by addressing your first question regarding the AQC. Part of the reason is the timing of the effort. The AQC began the process of looking into PQRI in December 2008 and continued making progress through the Spring 2009. We knew from the American Medical Association's CPT activities that Medicare was directing us toward a combined immittance code but we did not know what the designators were going to be, nor did we know at the time if the CPT editorial panel would accept the proposals for the combined codes. So this is one of the things that came about after the fact simply by virtue of the timing of when all of the PQRI audiology measures were approved versus the timing of when the new CPT codes appeared in the book. We have had discussions with CMS about this issue, and they have told us that they are aware of the new combined codes. They told us that they cannot amend this immediately re: PQRI but it is on their 'to do' list to amend as soon as possible.

Now for the other part of your question. Do we compromise quality of care by not performing necessary testing? No. To participate in PQRI, you can do other procedures in addition to the CPT codes approved for PQRI.

Dr. Cavitt: I would also add that just because audiologists are not able to report 92568 and 92567 for a patient re: PQRI, we can still report 92557 and have it count as the PQRI measure for that patient and have it apply to the bonus at the end of the year. While those two particular immittance codes (92567, 92568) may not be counted toward PQRI because you will be billing with a different code, there is no reason that the 92557 code for that patient cannot be counted.

Dr. Fifer: The AQC will continue to address this with CMS and we recommend that you monitor one of the websites of the AQC organizations for updates. The AQC member organizations are working together to ensure that all of the latest PQRI information is consistent and up to date on the following member websites, so stay tuned for more information as it arises: Academy of Doctors of Audiology (www.audiologist.org);American Academy of Audiology (www.audiology.org);American Speech-Language-Hearing Association (www.asha.org);Military Audiology Association (militaryaudiology.org).

This Ask the Expert was taken from the recorded course, An Audiologist's Guide to the Physician's Quality Reporting Initiative (PQRI), course #15289. To view the recorded course, register here

Kim Cavitt, Au.D. is the owner of her own Audiology consulting firm, Audiology Resources, Inc. Dr. Cavitt represents ADA on the Audiology Quality Consortium (AQC).

Robert C. Fifer, Ph.D. is Director of Audiology and Speech Language Pathology at the Mailman Center for Child Development at the University of Miami. Dr. Fifer represents ASHA on the Audiology Quality Consortium (AQC).