PQRI: E-Prescribing Reporting by Indiviual Eligible Professionals

2010 Electronic Prescribing Incentive Program – Adoption/Use of Medication
Electronic Prescribing Measure Release Notes
CMS is pleased to announce the release of the 2010 Electronic Prescribing (eRx) Incentive
Program – Adoption/Use of Medication Electronic Prescribing Measure Release Notes. Measure
developers, professional organizations, and other eRx stakeholders have provided comment,
clarifications, and technical corrections. The list below details changes to this existing measure
made since the release of the 2009 eRx Measure Specification.
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Reporting Option Updates
o 2010 REPORTING OPTIONS FOR THE ELECTRONIC PRESCRIBING
MEASURE: “ONLY FOR INDIVIDUAL CLAIMS-BASED AND REGISTRYBASED REPORTING (THESE SPECIFICATIONS DO NOT APPLY TO THE FOLLOWING
REPORTING OPTIONS: EHR-BASED SUBMISSION OR GROUP PRACTICE REPORTING
OPTION [GPRO].)”

o Added “Qualified” to ELECTRONIC PRESCRIBING (eRx) SYSTEM MUST HAVE
BEEN ADOPTED
•

Instruction Updates
o Updated: “In order to report this measure, a qualified eRx system that meets the
above requirements must have been adopted. The measure is to be reported for
those patient visits that meet the denominator coding criteria for which an
individual eligible professional has electronically prescribed at least one
prescription for a patient with Medicare Part B.”
o Added: “The diagnosis associated with the patient encounter that requires the eRx
may be used to report the eRx G-code. The individual eligible professional who
generates at least one eRx associated with a patient visit on 25 or more unique
events during the reporting period will be eligible for incentive payment.”
o Added to Measure Instructions, “Measure Reporting via Registry,” and “Measure
Reporting via Claims”
o Added to Measure Reporting via claims, “(Faxes do not qualify as electronic
prescribing).”
o Added to Measure Reporting via Registry, “A denominator CPT code and an
electronically generated and transmitted prescription (not faxed) are required to
report the measure.

•

Numerator Updates
o Updated: “A qualified eRx system (as specified above) has been adopted and the
following G-code applies to the patient visit.”
o Added to the Numerator coding: “and Transmitted” via Qualified eRx System
o Added to the Numerator coding: G8553: At least one electronic prescription
created during the encounter was generated and transmitted electronically using a
qualified eRx system.
o Deleted from Numerator coding: G8443, G8445, G8446

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Denominator Updates
o Deleted from the Denominator Coding: CPT codes 99348, 99241, 99242, 99243,
99244, 99245
o Added to the Denominator Coding: CPT codes 90862, 99304, 99305, 99306,
99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328,
99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348,
99349, 99350

•

Definitions Updates
o Added Definition: Electronic Prescribing Event – For the purposes of this
measure, an electronic prescribing event includes all prescriptions electronically
prescribed during a patient visit.
o Added Definition: Successful Individual Electronic Prescriber – Incentive
Eligible – A successful individual eRx prescriber, eligible to receive an incentive
payment, must generate and report one or more eRxs associated with a patient
visit, a minimum of 25 unique visits per year. Each visit must be accompanied by
the eRx G-code attesting that during the patient visit at least one prescription was
electronically prescribed. Electronically generated prescriptions not associated
with a denominator eligible patient visit do not count towards the minimum of 25
different eRx events. Additionally, 10% of an eligible professional’s Medicare Part
B charges must be comprised of the codes in the denominator of the measure to
be incentive eligible.
o Updated Definition: DME Supplies – Prescriptions for diabetic supplies may be
electronically prescribed. Some pharmacies may require additional documentation
secondary to internal policies which may be mandatory in case of audits; others
may require a signed copy of the order with signature to be kept for verification
purposes.

•

Global edits:
o Replaced e-prescribing with electronic prescribing or eRx throughout the
document
o Replaced “providers” with eligible professionals throughout the document
o Added “Individual” before eligible electronic (or eRx) prescriber

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